Abstract
Introduction Guidelines endorse to implement an integrated and multidisciplinary team approach in the management of people with Parkinson's disease (PD). However, there is no net and clear finding that shows the supremacy of multidisciplinary team interventions over conventional interventions for people with PD. Therefore, we perform a systematic review and meta-analysis to determine the supremacy of multidisciplinary interventions for people with PD. Methods A systematic review and meta-analysis of randomized controlled trials were conducted. PubMed, Physiotherapy Evidence Database, Cochrane Library, and Google Scholar were searched from inception until May 2021. Randomized controlled trials comparing multidisciplinary intervention with conventional physiotherapy were included. The outcome measures were gait balance, disability status, quality of life, and depression level. The PEDro scale was used to systematically appraise methodological quality. Two reviewers screened, extracted, and performed a quality assessment of included studies independently. Review Manager V.5.4 (Cochrane Collaboration) software was used for statistical analysis. Heterogeneity was analyzed using I2 statistics, and a standardized mean difference with 95% CI and Pvalue was used to calculate the treatment effect for outcome variables. Results A total of 6 studies with 1260 participants were included. The average PEDro methodological quality score was 6.67. No statistically significant difference between multidisciplinary and conventional rehabilitation on functional capacity (SMD: 0.69; 95% CI: −0.13, 1.51; P=0.10), disability status (SMD: 0.65; 95% CI: −0.16, 1.46; P=0.11), and quality of life (SMD: 0.28; 95% CI: −0.31, 0.59; P=0.08) was found. However, there is a statistically significant improvement in caregivers' anxiety levels in the multidisciplinary group (SMD: 0.39; 95% CI 0.06, 1.73; P=0.02). Conclusion This systematic review and meta-analysis show no significant difference between multidisciplinary and conventional rehabilitation on functionality, disability, and quality of life. Caregivers' anxiety levels show improvement following multidisciplinary interventions. However, large-scale studies with long-term follow-up were required for concrete and clinical recommendations.
Highlights
Guidelines endorse to implement an integrated and multidisciplinary team approach in the management of people with Parkinson’s disease (PD)
According to the World Health Organization (WHO), 6.1 million individuals have PD globally and it is expected that the trend will continue in the 30 years having approximately more than 12 million individuals suffering from PD [2, 3]
6 full-text studies with a total sample size of 1260 people fulfilled the inclusion criteria and were used for the analysis. e reasons for exclusion were inadequate randomization, non-multidisciplinary interventions, cross-over design, insufficient information, irrelevant outcomes, and other factors. e sample size included in the studies ranged from 43 to 762, and the inclusion and exclusion criteria were clearly stated in all studies
Summary
Guidelines endorse to implement an integrated and multidisciplinary team approach in the management of people with Parkinson’s disease (PD). Erefore, we perform a systematic review and meta-analysis to determine the supremacy of multidisciplinary interventions for people with PD. Randomized controlled trials comparing multidisciplinary intervention with conventional physiotherapy were included. No statistically significant difference between multidisciplinary and conventional rehabilitation on functional capacity (SMD: 0.69; 95% CI: −0.13, 1.51; P 0.10), disability status (SMD: 0.65; 95% CI: −0.16, 1.46; P 0.11), and quality of life (SMD: 0.28; 95% CI: −0.31, 0.59; P 0.08) was found. Is systematic review and meta-analysis show no significant difference between multidisciplinary and conventional rehabilitation on functionality, disability, and quality of life. Ere has been evidence for the inclusion of rehabilitation therapies as an adjuvant to pharmacological and neurosurgical treatment and a call for the move towards multidisciplinary management of this multidimensional condition [1, 3, 5] Treatment should focus on both motor and nonmotor symptoms of the disease. ere has been evidence for the inclusion of rehabilitation therapies as an adjuvant to pharmacological and neurosurgical treatment and a call for the move towards multidisciplinary management of this multidimensional condition [1, 3, 5]
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