Nondrug therapy in the combination rehabilitation of patients with Parkinson’s disease

Abstract

Non-drug rehabilitation in Parkinson’s disease (PD) has recently attracted the increasing attention of neurologists worldwide. Symptomatic medical treatment only prolongs the period of relative wellbeing and little affects the course of the disease, without preventing its progression. Today this raises the question of whether other or additional therapeutic approaches to rehabilitating patients with this disease should be sought. The elaboration and practical implementation of a program for multidisciplinary patient rehabilitation are most effective to date. This program includes combination therapy based on the use of current drugs and different variants of nondrug therapy. Within the current concept of medical treatment for PD, there are two strategic approaches: 1) to search for agents that are able to slow, delay, or stop its progression (the so-called neuroprotection) and 2) to develop more effective symptomatic therapies. The latter approach is presently considered to be basic. At large, more than 40-year experience in using dopaminergic and other antiparkinsonian agents indicates that this therapy cannot drastically solve the problem of PD treatment. So nondrug care methods whose improvement has become a relevant task of current therapeutic strategy in this disease are the focus of attention today. A nonpharmacological approach to treating PD is appropriate at all its stages. Here are just some of these methods: medicinal vacation, phototherapy, sleep deprivation, electroconvulsive therapy, and transcranial magnetic stimulation. Patients’ compliance to dietary advice is of significance. The experience shows that the most accessible and efficient and safe nondrug treatment is of course a package of measures to stimulate and restore a patient’s physical activity, which encompasses special functional training programs, kinesitherapy, multisensory training, physical exercises, etc. There is a need to further accumulate experience with nondrug therapy for PD to prove its therapeutic effectiveness and to promote its optimization.