Physiotherapy intervention in Parkinson’s disease: systematic review and meta-analysis
Identifieur interne : 000105 ( Ncbi/Merge ); précédent : 000104; suivant : 000106Physiotherapy intervention in Parkinson’s disease: systematic review and meta-analysis
Auteurs : Claire L. Tomlinson [Royaume-Uni] ; Smitaa Patel [Royaume-Uni] ; Charmaine Meek [Royaume-Uni] ; Clare P. Herd [Royaume-Uni] ; Carl E. Clarke [Royaume-Uni] ; Rebecca Stowe [Royaume-Uni] ; Laila Shah [Royaume-Uni] ; Catherine Sackley [Royaume-Uni] ; Katherine H O. Deane [Royaume-Uni] ; Keith Wheatley [Royaume-Uni] ; Natalie Ives [Royaume-Uni]Source :
- BMJ : British Medical Journal [ 0959-8138 ] ; 2012.
Abstract
Url:
DOI: 10.1136/bmj.e5004
PubMed: 22867913
PubMed Central: 3412755
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Deane</name><affiliation wicri:level="1"><nlm:aff id="aff4">University of East Anglia, Norwich, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of East Anglia, Norwich</wicri:regionArea><wicri:noRegion>Norwich</wicri:noRegion></affiliation></author><author><name sortKey="Wheatley, Keith" sort="Wheatley, Keith" uniqKey="Wheatley K" first="Keith" last="Wheatley">Keith Wheatley</name><affiliation wicri:level="4"><nlm:aff id="aff5">Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham</nlm:aff><country>Royaume-Uni</country><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName><orgName type="university">Université de Birmingham</orgName></affiliation></author><author><name sortKey="Ives, Natalie" sort="Ives, Natalie" uniqKey="Ives N" first="Natalie" last="Ives">Natalie Ives</name><affiliation wicri:level="4"><nlm:aff id="aff1">Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT</wicri:regionArea><orgName type="university">Université de Birmingham</orgName><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22867913</idno><idno type="pmc">3412755</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412755</idno><idno type="RBID">PMC:3412755</idno><idno type="doi">10.1136/bmj.e5004</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">000273</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000273</idno><idno type="wicri:Area/Pmc/Curation">000161</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000161</idno><idno type="wicri:Area/Pmc/Checkpoint">000102</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000102</idno><idno type="wicri:Area/Ncbi/Merge">000105</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Physiotherapy intervention in Parkinson’s disease: systematic review and meta-analysis </title><author><name sortKey="Tomlinson, Claire L" sort="Tomlinson, Claire L" uniqKey="Tomlinson C" first="Claire L" last="Tomlinson">Claire L. Tomlinson</name><affiliation wicri:level="4"><nlm:aff id="aff1">Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT</wicri:regionArea><orgName type="university">Université de Birmingham</orgName><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation></author><author><name sortKey="Patel, Smitaa" sort="Patel, Smitaa" uniqKey="Patel S" first="Smitaa" last="Patel">Smitaa Patel</name><affiliation wicri:level="4"><nlm:aff id="aff1">Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT</wicri:regionArea><orgName type="university">Université de Birmingham</orgName><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation></author><author><name sortKey="Meek, Charmaine" sort="Meek, Charmaine" uniqKey="Meek C" first="Charmaine" last="Meek">Charmaine Meek</name><affiliation wicri:level="4"><nlm:aff id="aff1">Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT</wicri:regionArea><orgName type="university">Université de Birmingham</orgName><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation></author><author><name sortKey="Herd, Clare P" sort="Herd, Clare P" uniqKey="Herd C" first="Clare P" last="Herd">Clare P. Herd</name><affiliation wicri:level="4"><nlm:aff id="aff2">School of Clinical and Experimental Medicine, College of Medicine and Dental Sciences, University of Birmingham</nlm:aff><country>Royaume-Uni</country><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName><orgName type="university">Université de Birmingham</orgName></affiliation></author><author><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E" last="Clarke">Carl E. Clarke</name><affiliation wicri:level="4"><nlm:aff id="aff2">School of Clinical and Experimental Medicine, College of Medicine and Dental Sciences, University of Birmingham</nlm:aff><country>Royaume-Uni</country><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName><orgName type="university">Université de Birmingham</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff3">Department of Neurology, Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham</nlm:aff><country>Royaume-Uni</country><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName><wicri:orgArea>Department of Neurology, Sandwell and West Birmingham Hospitals NHS Trust, City Hospital</wicri:orgArea></affiliation></author><author><name sortKey="Stowe, Rebecca" sort="Stowe, Rebecca" uniqKey="Stowe R" first="Rebecca" last="Stowe">Rebecca Stowe</name><affiliation wicri:level="4"><nlm:aff id="aff1">Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT</wicri:regionArea><orgName type="university">Université de Birmingham</orgName><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation></author><author><name sortKey="Shah, Laila" sort="Shah, Laila" uniqKey="Shah L" first="Laila" last="Shah">Laila Shah</name><affiliation wicri:level="4"><nlm:aff id="aff1">Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT</wicri:regionArea><orgName type="university">Université de Birmingham</orgName><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation></author><author><name sortKey="Sackley, Catherine" sort="Sackley, Catherine" uniqKey="Sackley C" first="Catherine" last="Sackley">Catherine Sackley</name><affiliation wicri:level="1"><nlm:aff id="aff4">University of East Anglia, Norwich, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of East Anglia, Norwich</wicri:regionArea><wicri:noRegion>Norwich</wicri:noRegion></affiliation></author><author><name sortKey="Deane, Katherine H O" sort="Deane, Katherine H O" uniqKey="Deane K" first="Katherine H O" last="Deane">Katherine H O. Deane</name><affiliation wicri:level="1"><nlm:aff id="aff4">University of East Anglia, Norwich, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of East Anglia, Norwich</wicri:regionArea><wicri:noRegion>Norwich</wicri:noRegion></affiliation></author><author><name sortKey="Wheatley, Keith" sort="Wheatley, Keith" uniqKey="Wheatley K" first="Keith" last="Wheatley">Keith Wheatley</name><affiliation wicri:level="4"><nlm:aff id="aff5">Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham</nlm:aff><country>Royaume-Uni</country><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName><orgName type="university">Université de Birmingham</orgName></affiliation></author><author><name sortKey="Ives, Natalie" sort="Ives, Natalie" uniqKey="Ives N" first="Natalie" last="Ives">Natalie Ives</name><affiliation wicri:level="4"><nlm:aff id="aff1">Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT</wicri:regionArea><orgName type="university">Université de Birmingham</orgName><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation></author></analytic><series><title level="j">BMJ : British Medical Journal</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1756-1833</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Objective</bold> To assess the effectiveness of physiotherapy compared with no intervention in patients with Parkinson’s disease.</p><p><bold>Design</bold> Systematic review and meta-analysis of randomised controlled trials.</p><p><bold>Data sources</bold> Literature databases, trial registries, journals, abstract books, and conference proceedings, and reference lists, searched up to the end of January 2012.</p><p><bold>Review methods</bold> Randomised controlled trials comparing physiotherapy with no intervention in patients with Parkinson’s disease were eligible. Two authors independently abstracted data from each trial. Standard meta-analysis methods were used to assess the effectiveness of physiotherapy compared with no intervention. Tests for heterogeneity were used to assess for differences in treatment effect across different physiotherapy interventions used. Outcome measures were gait, functional mobility and balance, falls, clinician rated impairment and disability measures, patient rated quality of life, adverse events, compliance, and economic analysis outcomes.</p><p><bold>Results</bold> 39 trials of 1827 participants met the inclusion criteria, of which 29 trials provided data for the meta-analyses. Significant benefit from physiotherapy was reported for nine of 18 outcomes assessed. Outcomes which may be clinically significant were speed (0.04 m/s, 95% confidence interval 0.02 to 0.06, P<0.001), Berg balance scale (3.71 points, 2.30 to 5.11, P<0.001), and scores on the unified Parkinson’s disease rating scale (total score −6.15 points, −8.57 to −3.73, P<0.001; activities of daily living subscore −1.36, −2.41 to −0.30, P=0.01; motor subscore −5.01, −6.30 to −3.72, P<0.001). Indirect comparisons of the different physiotherapy interventions found no evidence that the treatment effect differed across the interventions for any outcomes assessed, apart from motor subscores on the unified Parkinson’s disease rating scale (in which one trial was found to be the cause of the heterogeneity).</p><p><bold>Conclusions</bold> Physiotherapy has short term benefits in Parkinson’s disease. A wide range of physiotherapy techniques are currently used to treat Parkinson’s disease, with little difference in treatment effects. Large, well designed, randomised controlled trials with improved methodology and reporting are needed to assess the efficacy and cost effectiveness of physiotherapy for treating Parkinson’s disease in the longer term.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMJ</journal-id><journal-id journal-id-type="iso-abbrev">BMJ</journal-id><journal-id journal-id-type="publisher-id">bmj</journal-id><journal-title-group><journal-title>BMJ : British Medical Journal</journal-title></journal-title-group><issn pub-type="ppub">0959-8138</issn><issn pub-type="epub">1756-1833</issn><publisher><publisher-name>BMJ Publishing Group Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22867913</article-id><article-id pub-id-type="pmc">3412755</article-id><article-id pub-id-type="publisher-id">tomc002253</article-id><article-id pub-id-type="doi">10.1136/bmj.e5004</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>1778</subject></subj-group><subj-group subj-group-type="hw-coll-titles"><subject>Health Policy</subject><subject>Clinical Trials (Epidemiology)</subject><subject>UK</subject><subject>Physiotherapy</subject><subject>Sports and Exercise Medicine</subject><subject>Health Economics</subject><subject>Health Service Research</subject><subject>Sociology</subject></subj-group></article-categories><title-group><article-title>Physiotherapy intervention in Parkinson’s disease: systematic review and meta-analysis </article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Tomlinson</surname><given-names>Claire L</given-names></name><role>systematic reviewer</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Patel</surname><given-names>Smitaa</given-names></name><role>statistician</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Meek</surname><given-names>Charmaine</given-names></name><role>research assistant</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Herd</surname><given-names>Clare P</given-names></name><role>research associate</role><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Clarke</surname><given-names>Carl E</given-names></name><role>professor</role><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Stowe</surname><given-names>Rebecca</given-names></name><role>senior systematic reviewer</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Shah</surname><given-names>Laila</given-names></name><role>research administrator</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Sackley</surname><given-names>Catherine</given-names></name><role>professor of physiotherapy research</role><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Deane</surname><given-names>Katherine H O</given-names></name><role>senior lecturer in research</role><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Wheatley</surname><given-names>Keith</given-names></name><role>professor</role><xref ref-type="aff" rid="aff5">5</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Ives</surname><given-names>Natalie</given-names></name><role>senior statistician</role><xref ref-type="aff" rid="aff1">1</xref></contrib><aff id="aff1"><label>1</label>Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT, UK</aff><aff id="aff2"><label>2</label>School of Clinical and Experimental Medicine, College of Medicine and Dental Sciences, University of Birmingham</aff><aff id="aff3"><label>3</label>Department of Neurology, Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham</aff><aff id="aff4"><label>4</label>University of East Anglia, Norwich, UK</aff><aff id="aff5"><label>5</label>Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham</aff></contrib-group><author-notes><corresp>Correspondence to: C Tomlinson <email>c.l.smith.1@bham.ac.uk</email></corresp></author-notes><pmc-comment>For BMJ, both ppub and collection dates generated for PMC processing starting July 2008 beck</pmc-comment>
<pub-date pub-type="collection"><year>2012</year></pub-date><pub-date pub-type="ppub"><year>2012</year></pub-date><pub-date pub-type="epub"><day>06</day><month>8</month><year>2012</year></pub-date><volume>345</volume><elocation-id>e5004</elocation-id><history><date date-type="accepted"><day>04</day><month>7</month><year>2012</year></date></history><permissions><copyright-statement>© Tomlinson et al 2012</copyright-statement><copyright-year>2012</copyright-year><copyright-holder>Tomlinson et al</copyright-holder><license license-type="open-access"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/">http://creativecommons.org/licenses/by-nc/2.0/</ext-link> and <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/legalcode">http://creativecommons.org/licenses/by-nc/2.0/legalcode</ext-link>.</license-p></license></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="bmj.e5004.pdf"></self-uri><abstract><p><bold>Objective</bold> To assess the effectiveness of physiotherapy compared with no intervention in patients with Parkinson’s disease.</p><p><bold>Design</bold> Systematic review and meta-analysis of randomised controlled trials.</p><p><bold>Data sources</bold> Literature databases, trial registries, journals, abstract books, and conference proceedings, and reference lists, searched up to the end of January 2012.</p><p><bold>Review methods</bold> Randomised controlled trials comparing physiotherapy with no intervention in patients with Parkinson’s disease were eligible. Two authors independently abstracted data from each trial. Standard meta-analysis methods were used to assess the effectiveness of physiotherapy compared with no intervention. Tests for heterogeneity were used to assess for differences in treatment effect across different physiotherapy interventions used. Outcome measures were gait, functional mobility and balance, falls, clinician rated impairment and disability measures, patient rated quality of life, adverse events, compliance, and economic analysis outcomes.</p><p><bold>Results</bold> 39 trials of 1827 participants met the inclusion criteria, of which 29 trials provided data for the meta-analyses. Significant benefit from physiotherapy was reported for nine of 18 outcomes assessed. Outcomes which may be clinically significant were speed (0.04 m/s, 95% confidence interval 0.02 to 0.06, P<0.001), Berg balance scale (3.71 points, 2.30 to 5.11, P<0.001), and scores on the unified Parkinson’s disease rating scale (total score −6.15 points, −8.57 to −3.73, P<0.001; activities of daily living subscore −1.36, −2.41 to −0.30, P=0.01; motor subscore −5.01, −6.30 to −3.72, P<0.001). Indirect comparisons of the different physiotherapy interventions found no evidence that the treatment effect differed across the interventions for any outcomes assessed, apart from motor subscores on the unified Parkinson’s disease rating scale (in which one trial was found to be the cause of the heterogeneity).</p><p><bold>Conclusions</bold> Physiotherapy has short term benefits in Parkinson’s disease. A wide range of physiotherapy techniques are currently used to treat Parkinson’s disease, with little difference in treatment effects. Large, well designed, randomised controlled trials with improved methodology and reporting are needed to assess the efficacy and cost effectiveness of physiotherapy for treating Parkinson’s disease in the longer term.</p></abstract></article-meta><notes notes-type="data-supplement"><label>Web Extra</label><title>Extra material supplied by the author</title><supplementary-material content-type="local-data"><caption><p><bold>Web table 1:</bold> Characteristics of included studies</p></caption><media xlink:href="tomc002253.wt1_default.pdf" mimetype="application" mime-subtype="pdf"><caption><p>Click here for additional data file.</p></caption></media></supplementary-material><supplementary-material content-type="local-data"><caption><p><bold>Web table 2:</bold> Risk of bias in included studies</p></caption><media xlink:href="tomc002253.wt2_default.pdf" mimetype="application" mime-subtype="pdf"><caption><p>Click here for additional data file.</p></caption></media></supplementary-material><supplementary-material content-type="local-data"><caption><p><bold>Web figure 1:</bold> Two or six min walk test (m)</p></caption><media xlink:href="tomc002253.wf1_default.pdf" mimetype="application" mime-subtype="pdf"><caption><p>Click here for additional data file.</p></caption></media></supplementary-material><supplementary-material content-type="local-data"><caption><p><bold>Web figure 2:</bold> Freezing of gait questionnaire</p></caption><media xlink:href="tomc002253.wf2_default.pdf" mimetype="application" mime-subtype="pdf"><caption><p>Click here for additional data file.</p></caption></media></supplementary-material><supplementary-material content-type="local-data"><caption><p><bold>Web figure 3:</bold> 10 or 20 m walk test (s)</p></caption><media xlink:href="tomc002253.wf3_default.pdf" mimetype="application" mime-subtype="pdf"><caption><p>Click here for additional data file.</p></caption></media></supplementary-material><supplementary-material content-type="local-data"><caption><p><bold>Web figure 4:</bold> Unified Parkinson’s disease rating scale – activities of daily living</p></caption><media xlink:href="tomc002253.wf4_default.pdf" mimetype="application" mime-subtype="pdf"><caption><p>Click here for additional data file.</p></caption></media></supplementary-material><supplementary-material content-type="local-data"><caption><p><bold>Web figure 5:</bold> Unified Parkinson’s disease rating scale – total score</p></caption><media xlink:href="tomc002253.wf5_default.pdf" mimetype="application" mime-subtype="pdf"><caption><p>Click here for additional data file.</p></caption></media></supplementary-material></notes></front></pmc><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Midlands de l'Ouest</li></region><settlement><li>Birmingham</li></settlement><orgName><li>Université de Birmingham</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Tomlinson, Claire L" sort="Tomlinson, Claire L" uniqKey="Tomlinson C" first="Claire L" last="Tomlinson">Claire L. Tomlinson</name></region><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E" last="Clarke">Carl E. Clarke</name><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E" last="Clarke">Carl E. Clarke</name><name sortKey="Deane, Katherine H O" sort="Deane, Katherine H O" uniqKey="Deane K" first="Katherine H O" last="Deane">Katherine H O. Deane</name><name sortKey="Herd, Clare P" sort="Herd, Clare P" uniqKey="Herd C" first="Clare P" last="Herd">Clare P. Herd</name><name sortKey="Ives, Natalie" sort="Ives, Natalie" uniqKey="Ives N" first="Natalie" last="Ives">Natalie Ives</name><name sortKey="Meek, Charmaine" sort="Meek, Charmaine" uniqKey="Meek C" first="Charmaine" last="Meek">Charmaine Meek</name><name sortKey="Patel, Smitaa" sort="Patel, Smitaa" uniqKey="Patel S" first="Smitaa" last="Patel">Smitaa Patel</name><name sortKey="Sackley, Catherine" sort="Sackley, Catherine" uniqKey="Sackley C" first="Catherine" last="Sackley">Catherine Sackley</name><name sortKey="Shah, Laila" sort="Shah, Laila" uniqKey="Shah L" first="Laila" last="Shah">Laila Shah</name><name sortKey="Stowe, Rebecca" sort="Stowe, Rebecca" uniqKey="Stowe R" first="Rebecca" last="Stowe">Rebecca Stowe</name><name sortKey="Wheatley, Keith" sort="Wheatley, Keith" uniqKey="Wheatley K" first="Keith" last="Wheatley">Keith Wheatley</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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