Systematic review of paramedical therapies for Parkinson's disease.
Identifieur interne : 000897 ( Ncbi/Curation ); précédent : 000896; suivant : 000898Systematic review of paramedical therapies for Parkinson's disease.
Auteurs : Katherine H O. Deane [Royaume-Uni] ; Caroline Ellis-Hill ; Diana Jones ; Renata Whurr ; Yoav Ben-Shlomo ; E Diane Playford ; Carl E. ClarkeSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2002.
English descriptors
- KwdEn :
- Activities of Daily Living, Dysarthria (etiology), Dysarthria (therapy), Humans, Language Therapy, Movement Disorders (etiology), Movement Disorders (therapy), Occupational Therapy, Parkinson Disease (complications), Parkinson Disease (therapy), Physical Therapy Modalities, Quality of Life, Randomized Controlled Trials as Topic, Speech Therapy.
- MESH :
- complications : Parkinson Disease.
- etiology : Dysarthria, Movement Disorders.
- therapy : Dysarthria, Movement Disorders, Parkinson Disease.
- Activities of Daily Living, Humans, Language Therapy, Occupational Therapy, Physical Therapy Modalities, Quality of Life, Randomized Controlled Trials as Topic, Speech Therapy.
Abstract
We evaluated the efficacy of physiotherapy, occupational therapy, and speech and language therapy in Parkinson's disease by synthesizing six Cochrane systematic reviews. All randomised, controlled trials examining the efficacy of a paramedical therapy versus control intervention and all those comparing the efficacy of two forms of active therapy in Parkinson's disease were included. Trials were identified by searching biomedical databases, reference lists, hand searching, and contacting investigators. The main outcome measures were quality of life, speech intelligibility, activities of daily living, and individual measures of motor and speech impairment. We identified 16 physiotherapy randomised controlled trials (399 patients), two occupational therapy trials (84 patients), and five speech and language therapy for dysarthria trials (154 patients). None of these studies examined nonpharmacological swallowing therapy for dysphagia. We were unable to perform meta-analysis of the results because the trials used heterogeneous therapy methods and outcome measures. The trials also had marked methodological flaws that could have introduced bias. In summary, we failed to find conclusive evidence of benefit for any form of paramedical therapy sufficient to recommend them in routine clinical practice. However, this lack of evidence is not proof of a lack of effect. Further large pragmatic randomised controlled trials are required to determine the effectiveness of paramedical therapies in Parkinson's disease.
DOI: 10.1002/mds.10197
PubMed: 12360547
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Systematic review of paramedical therapies for Parkinson's disease.</title><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="4"><nlm:affiliation>Department of Neurology, City Hospital NHS Trust, and The University of Birmingham, Birmingham, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neurology, City Hospital NHS Trust, and The University of Birmingham, Birmingham</wicri:regionArea><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="Ellis Hill, Caroline" sort="Ellis Hill, Caroline" uniqKey="Ellis Hill C" first="Caroline" last="Ellis-Hill">Caroline Ellis-Hill</name></author><author><name sortKey="Jones, Diana" sort="Jones, Diana" uniqKey="Jones D" first="Diana" last="Jones">Diana Jones</name></author><author><name sortKey="Whurr, Renata" sort="Whurr, Renata" uniqKey="Whurr R" first="Renata" last="Whurr">Renata Whurr</name></author><author><name sortKey="Ben Shlomo, Yoav" sort="Ben Shlomo, Yoav" uniqKey="Ben Shlomo Y" first="Yoav" last="Ben-Shlomo">Yoav Ben-Shlomo</name></author><author><name sortKey="Playford, E Diane" sort="Playford, E Diane" uniqKey="Playford E" first="E Diane" last="Playford">E Diane Playford</name></author><author><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E" last="Clarke">Carl E. 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Deane</name><affiliation wicri:level="4"><nlm:affiliation>Department of Neurology, City Hospital NHS Trust, and The University of Birmingham, Birmingham, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neurology, City Hospital NHS Trust, and The University of Birmingham, Birmingham</wicri:regionArea><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="Ellis Hill, Caroline" sort="Ellis Hill, Caroline" uniqKey="Ellis Hill C" first="Caroline" last="Ellis-Hill">Caroline Ellis-Hill</name></author><author><name sortKey="Jones, Diana" sort="Jones, Diana" uniqKey="Jones D" first="Diana" last="Jones">Diana Jones</name></author><author><name sortKey="Whurr, Renata" sort="Whurr, Renata" uniqKey="Whurr R" first="Renata" last="Whurr">Renata Whurr</name></author><author><name sortKey="Ben Shlomo, Yoav" sort="Ben Shlomo, Yoav" uniqKey="Ben Shlomo Y" first="Yoav" last="Ben-Shlomo">Yoav Ben-Shlomo</name></author><author><name sortKey="Playford, E Diane" sort="Playford, E Diane" uniqKey="Playford E" first="E Diane" last="Playford">E Diane Playford</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></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2002" type="published">2002</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living</term><term>Dysarthria (etiology)</term><term>Dysarthria (therapy)</term><term>Humans</term><term>Language Therapy</term><term>Movement Disorders (etiology)</term><term>Movement Disorders (therapy)</term><term>Occupational Therapy</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (therapy)</term><term>Physical Therapy Modalities</term><term>Quality of Life</term><term>Randomized Controlled Trials as Topic</term><term>Speech Therapy</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Dysarthria</term><term>Movement Disorders</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Dysarthria</term><term>Movement Disorders</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Activities of Daily Living</term><term>Humans</term><term>Language Therapy</term><term>Occupational Therapy</term><term>Physical Therapy Modalities</term><term>Quality of Life</term><term>Randomized Controlled Trials as Topic</term><term>Speech Therapy</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We evaluated the efficacy of physiotherapy, occupational therapy, and speech and language therapy in Parkinson's disease by synthesizing six Cochrane systematic reviews. All randomised, controlled trials examining the efficacy of a paramedical therapy versus control intervention and all those comparing the efficacy of two forms of active therapy in Parkinson's disease were included. Trials were identified by searching biomedical databases, reference lists, hand searching, and contacting investigators. The main outcome measures were quality of life, speech intelligibility, activities of daily living, and individual measures of motor and speech impairment. We identified 16 physiotherapy randomised controlled trials (399 patients), two occupational therapy trials (84 patients), and five speech and language therapy for dysarthria trials (154 patients). None of these studies examined nonpharmacological swallowing therapy for dysphagia. We were unable to perform meta-analysis of the results because the trials used heterogeneous therapy methods and outcome measures. The trials also had marked methodological flaws that could have introduced bias. In summary, we failed to find conclusive evidence of benefit for any form of paramedical therapy sufficient to recommend them in routine clinical practice. However, this lack of evidence is not proof of a lack of effect. Further large pragmatic randomised controlled trials are required to determine the effectiveness of paramedical therapies in Parkinson's disease.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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