Physiotherapy for Parkinson's disease: a comparison of techniques.
Identifieur interne : 000012 ( PubMed/Curation ); précédent : 000011; suivant : 000013Physiotherapy for Parkinson's disease: a comparison of techniques.
Auteurs : Claire L. Tomlinson [Royaume-Uni] ; Clare P. Herd ; Carl E. Clarke ; Charmaine Meek ; Smitaa Patel ; Rebecca Stowe ; Katherine H O. Deane ; Laila Shah ; Catherine M. Sackley ; Keith Wheatley ; Natalie IvesSource :
- The Cochrane database of systematic reviews [ 1469-493X ] ; 2014.
Descripteurs français
- KwdFr :
- MESH :
- physiologie : Démarche.
- rééducation et réadaptation : Maladie de Parkinson.
- Essais contrôlés randomisés comme sujet, Humains, Techniques de physiothérapie.
English descriptors
- KwdEn :
- MESH :
- physiology : Gait.
- rehabilitation : Parkinson Disease.
- Humans, Physical Therapy Modalities, Randomized Controlled Trials as Topic.
Abstract
BACKGROUND
Despite medical therapies and surgical interventions for Parkinson's disease (PD), patients develop progressive disability. The role of physiotherapy is to maximise functional ability and minimise secondary complications through movement rehabilitation within a context of education and support for the whole person. The overall aim is to optimise independence, safety and wellbeing, thereby enhancing quality of life. Trials have shown that physiotherapy has short-term benefits in PD. However, which physiotherapy intervention is most effective remains unclear.
OBJECTIVES
To assess the effectiveness of one physiotherapy intervention compared with a second approach in patients with PD.
SEARCH METHODS
Relevant trials were identified by electronic searches of numerous literature databases (for example MEDLINE, EMBASE) and trial registers, plus handsearching of major journals, abstract books, conference proceedings and reference lists of retrieved publications. The literature search included trials published up to the end of January 2012.
SELECTION CRITERIA
Randomised controlled trials of one physiotherapy intervention versus another physiotherapy intervention in patients with PD.
DATA COLLECTION AND ANALYSIS
Data were abstracted independently from each paper by two authors. Trials were classified into the following intervention comparisons: general physiotherapy, exercise, treadmill training, cueing, dance and martial arts.
MAIN RESULTS
A total of 43 trials were identified with 1673 participants. All trials used small patient numbers (average trial size of 39 participants); the methods of randomisation and concealment of allocation were poor or not stated in most trials. Blinded assessors were used in just over half of the trials and only 10 stated that they used intention-to-treat analysis.A wide variety of validated and customised outcome measures were used to assess the effectiveness of physiotherapy interventions. The most frequently reported physiotherapy outcomes were gait speed and timed up and go, in 19 and 15 trials respectively. Only five of the 43 trials reported data on falls (12%). The motor subscales of the Unified Parkinson's Disease Rating Scale and Parkinson's Disease Questionnaire-39 were the most commonly reported clinician-rated disability and patient-rated quality of life outcome measures, used in 22 and 13 trials respectively. The content and delivery of the physiotherapy interventions varied widely in the trials included within this review, so no quantitative meta-analysis could be performed.
AUTHORS' CONCLUSIONS
Considering the small number of participants examined, the methodological flaws in many of the studies, the possibility of publication bias, and the variety of interventions, formal comparison of the different physiotherapy techniques could not be performed. There is insufficient evidence to support or refute the effectiveness of one physiotherapy intervention over another in PD.This review shows that a wide range of physiotherapy interventions to treat PD have been tested . There is a need for more specific trials with improved treatment strategies to underpin the most appropriate choice of physiotherapy intervention and the outcomes measured.
DOI: 10.1002/14651858.CD002815.pub2
PubMed: 24936965
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Tomlinson</name><affiliation wicri:level="4"><nlm:affiliation>Birmingham Clinical Trials Unit, University of Birmingham, Robert Aitken Institute, Edgbaston, Birmingham, UK, B15 2TT.</nlm:affiliation><orgName type="university">Université de Birmingham</orgName><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></affiliation></author><author><name sortKey="Herd, Clare P" sort="Herd, Clare P" uniqKey="Herd C" first="Clare P" last="Herd">Clare P. Herd</name></author><author><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E" last="Clarke">Carl E. Clarke</name></author><author><name sortKey="Meek, Charmaine" sort="Meek, Charmaine" uniqKey="Meek C" first="Charmaine" last="Meek">Charmaine Meek</name></author><author><name sortKey="Patel, Smitaa" sort="Patel, Smitaa" uniqKey="Patel S" first="Smitaa" last="Patel">Smitaa Patel</name></author><author><name sortKey="Stowe, Rebecca" sort="Stowe, Rebecca" uniqKey="Stowe R" first="Rebecca" last="Stowe">Rebecca Stowe</name></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></author><author><name sortKey="Shah, Laila" sort="Shah, Laila" uniqKey="Shah L" first="Laila" last="Shah">Laila Shah</name></author><author><name sortKey="Sackley, Catherine M" sort="Sackley, Catherine M" uniqKey="Sackley C" first="Catherine M" last="Sackley">Catherine M. Sackley</name></author><author><name sortKey="Wheatley, Keith" sort="Wheatley, Keith" uniqKey="Wheatley K" first="Keith" last="Wheatley">Keith Wheatley</name></author><author><name sortKey="Ives, Natalie" sort="Ives, Natalie" uniqKey="Ives N" first="Natalie" last="Ives">Natalie Ives</name></author></analytic><series><title level="j">The Cochrane database of systematic reviews</title><idno type="eISSN">1469-493X</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Gait (physiology)</term><term>Humans (MeSH)</term><term>Parkinson Disease (rehabilitation)</term><term>Physical Therapy Modalities (MeSH)</term><term>Randomized Controlled Trials as Topic (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Démarche (physiologie)</term><term>Essais contrôlés randomisés comme sujet (MeSH)</term><term>Humains (MeSH)</term><term>Maladie de Parkinson (rééducation et réadaptation)</term><term>Techniques de physiothérapie (MeSH)</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Démarche</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Gait</term></keywords><keywords scheme="MESH" qualifier="rehabilitation" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="rééducation et réadaptation" xml:lang="fr"><term>Maladie de Parkinson</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Physical Therapy Modalities</term><term>Randomized Controlled Trials as Topic</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Essais contrôlés randomisés comme sujet</term><term>Humains</term><term>Techniques de physiothérapie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Despite medical therapies and surgical interventions for Parkinson's disease (PD), patients develop progressive disability. The role of physiotherapy is to maximise functional ability and minimise secondary complications through movement rehabilitation within a context of education and support for the whole person. The overall aim is to optimise independence, safety and wellbeing, thereby enhancing quality of life. Trials have shown that physiotherapy has short-term benefits in PD. However, which physiotherapy intervention is most effective remains unclear.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>To assess the effectiveness of one physiotherapy intervention compared with a second approach in patients with PD.</p></div><div type="abstract" xml:lang="en"><p><b>SEARCH METHODS</b></p><p>Relevant trials were identified by electronic searches of numerous literature databases (for example MEDLINE, EMBASE) and trial registers, plus handsearching of major journals, abstract books, conference proceedings and reference lists of retrieved publications. The literature search included trials published up to the end of January 2012.</p></div><div type="abstract" xml:lang="en"><p><b>SELECTION CRITERIA</b></p><p>Randomised controlled trials of one physiotherapy intervention versus another physiotherapy intervention in patients with PD.</p></div><div type="abstract" xml:lang="en"><p><b>DATA COLLECTION AND ANALYSIS</b></p><p>Data were abstracted independently from each paper by two authors. Trials were classified into the following intervention comparisons: general physiotherapy, exercise, treadmill training, cueing, dance and martial arts.</p></div><div type="abstract" xml:lang="en"><p><b>MAIN RESULTS</b></p><p>A total of 43 trials were identified with 1673 participants. All trials used small patient numbers (average trial size of 39 participants); the methods of randomisation and concealment of allocation were poor or not stated in most trials. Blinded assessors were used in just over half of the trials and only 10 stated that they used intention-to-treat analysis.A wide variety of validated and customised outcome measures were used to assess the effectiveness of physiotherapy interventions. The most frequently reported physiotherapy outcomes were gait speed and timed up and go, in 19 and 15 trials respectively. Only five of the 43 trials reported data on falls (12%). The motor subscales of the Unified Parkinson's Disease Rating Scale and Parkinson's Disease Questionnaire-39 were the most commonly reported clinician-rated disability and patient-rated quality of life outcome measures, used in 22 and 13 trials respectively. The content and delivery of the physiotherapy interventions varied widely in the trials included within this review, so no quantitative meta-analysis could be performed.</p></div><div type="abstract" xml:lang="en"><p><b>AUTHORS' CONCLUSIONS</b></p><p>Considering the small number of participants examined, the methodological flaws in many of the studies, the possibility of publication bias, and the variety of interventions, formal comparison of the different physiotherapy techniques could not be performed. There is insufficient evidence to support or refute the effectiveness of one physiotherapy intervention over another in PD.This review shows that a wide range of physiotherapy interventions to treat PD have been tested . There is a need for more specific trials with improved treatment strategies to underpin the most appropriate choice of physiotherapy intervention and the outcomes measured.</p></div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">24936965</PMID><DateCreated><Year>2014</Year><Month>07</Month><Day>02</Day></DateCreated><DateCompleted><Year>2015</Year><Month>10</Month><Day>02</Day></DateCompleted><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1469-493X</ISSN><JournalIssue CitedMedium="Internet"><Volume>6</Volume><PubDate><Year>2014</Year></PubDate></JournalIssue><Title>The Cochrane database of systematic reviews</Title><ISOAbbreviation>Cochrane Database Syst Rev</ISOAbbreviation></Journal><ArticleTitle>Physiotherapy for Parkinson's disease: a comparison of techniques.</ArticleTitle><Pagination><MedlinePgn>CD002815</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/14651858.CD002815.pub2</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Despite medical therapies and surgical interventions for Parkinson's disease (PD), patients develop progressive disability. The role of physiotherapy is to maximise functional ability and minimise secondary complications through movement rehabilitation within a context of education and support for the whole person. The overall aim is to optimise independence, safety and wellbeing, thereby enhancing quality of life. Trials have shown that physiotherapy has short-term benefits in PD. However, which physiotherapy intervention is most effective remains unclear.</AbstractText><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To assess the effectiveness of one physiotherapy intervention compared with a second approach in patients with PD.</AbstractText><AbstractText Label="SEARCH METHODS" NlmCategory="METHODS">Relevant trials were identified by electronic searches of numerous literature databases (for example MEDLINE, EMBASE) and trial registers, plus handsearching of major journals, abstract books, conference proceedings and reference lists of retrieved publications. The literature search included trials published up to the end of January 2012.</AbstractText><AbstractText Label="SELECTION CRITERIA" NlmCategory="METHODS">Randomised controlled trials of one physiotherapy intervention versus another physiotherapy intervention in patients with PD.</AbstractText><AbstractText Label="DATA COLLECTION AND ANALYSIS" NlmCategory="METHODS">Data were abstracted independently from each paper by two authors. Trials were classified into the following intervention comparisons: general physiotherapy, exercise, treadmill training, cueing, dance and martial arts.</AbstractText><AbstractText Label="MAIN RESULTS" NlmCategory="RESULTS">A total of 43 trials were identified with 1673 participants. All trials used small patient numbers (average trial size of 39 participants); the methods of randomisation and concealment of allocation were poor or not stated in most trials. Blinded assessors were used in just over half of the trials and only 10 stated that they used intention-to-treat analysis.A wide variety of validated and customised outcome measures were used to assess the effectiveness of physiotherapy interventions. The most frequently reported physiotherapy outcomes were gait speed and timed up and go, in 19 and 15 trials respectively. Only five of the 43 trials reported data on falls (12%). The motor subscales of the Unified Parkinson's Disease Rating Scale and Parkinson's Disease Questionnaire-39 were the most commonly reported clinician-rated disability and patient-rated quality of life outcome measures, used in 22 and 13 trials respectively. The content and delivery of the physiotherapy interventions varied widely in the trials included within this review, so no quantitative meta-analysis could be performed.</AbstractText><AbstractText Label="AUTHORS' CONCLUSIONS" NlmCategory="CONCLUSIONS">Considering the small number of participants examined, the methodological flaws in many of the studies, the possibility of publication bias, and the variety of interventions, formal comparison of the different physiotherapy techniques could not be performed. There is insufficient evidence to support or refute the effectiveness of one physiotherapy intervention over another in PD.This review shows that a wide range of physiotherapy interventions to treat PD have been tested . There is a need for more specific trials with improved treatment strategies to underpin the most appropriate choice of physiotherapy intervention and the outcomes measured.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Tomlinson</LastName><ForeName>Claire L</ForeName><Initials>CL</Initials><AffiliationInfo><Affiliation>Birmingham Clinical Trials Unit, University of Birmingham, Robert Aitken Institute, Edgbaston, Birmingham, UK, B15 2TT.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Herd</LastName><ForeName>Clare P</ForeName><Initials>CP</Initials></Author><Author ValidYN="Y"><LastName>Clarke</LastName><ForeName>Carl E</ForeName><Initials>CE</Initials></Author><Author ValidYN="Y"><LastName>Meek</LastName><ForeName>Charmaine</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Patel</LastName><ForeName>Smitaa</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Stowe</LastName><ForeName>Rebecca</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Deane</LastName><ForeName>Katherine H O</ForeName><Initials>KH</Initials></Author><Author ValidYN="Y"><LastName>Shah</LastName><ForeName>Laila</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Sackley</LastName><ForeName>Catherine M</ForeName><Initials>CM</Initials></Author><Author ValidYN="Y"><LastName>Wheatley</LastName><ForeName>Keith</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Ives</LastName><ForeName>Natalie</ForeName><Initials>N</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><Agency>Department of Health</Agency><Country>United Kingdom</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2014</Year><Month>06</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Cochrane Database Syst Rev</MedlineTA><NlmUniqueID>100909747</NlmUniqueID><ISSNLinking>1361-6137</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="UpdateOf"><RefSource>Cochrane Database Syst Rev. 2001;(1):CD002815</RefSource><PMID Version="1">11279765</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005684">Gait</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000502">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D010300">Parkinson Disease</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000534">rehabilitation</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y" UI="D026741">Physical Therapy Modalities</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D016032">Randomized Controlled Trials as Topic</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2014</Year><Month>6</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2014</Year><Month>6</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2015</Year><Month>10</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="doi">10.1002/14651858.CD002815.pub2</ArticleId><ArticleId IdType="pubmed">24936965</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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