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Systematic review of paramedical therapies for Parkinson's disease

Systematic review of paramedical therapies for Parkinson's disease
Systematic review of paramedical therapies for Parkinson's disease
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.
parkinson's disease, physiotherapy, occupational therapy, speech and language therapy, systematic review
984-991
Deane, Katherine H.O.
ce65c532-64f8-4d75-9ea5-19fd870fce0c
Ellis-Hill, Caroline
8869242e-5047-4127-a63e-00858ff5a993
Jones, Diana
ab8396d9-c83e-4204-818f-7c6936014ea1
Whurr, Renatta
df320296-e413-44f9-b035-e51f17d1b8d4
Ben-Shlomo, Yoav
df80bd02-a908-4296-b293-825d42203729
Playford, E. Diane
51707e0d-5490-4d2f-99cc-cd6297464d61
Clarke, Carl E.
43fb4fd1-46bf-470e-b08d-8ffff4351a53
Deane, Katherine H.O.
ce65c532-64f8-4d75-9ea5-19fd870fce0c
Ellis-Hill, Caroline
8869242e-5047-4127-a63e-00858ff5a993
Jones, Diana
ab8396d9-c83e-4204-818f-7c6936014ea1
Whurr, Renatta
df320296-e413-44f9-b035-e51f17d1b8d4
Ben-Shlomo, Yoav
df80bd02-a908-4296-b293-825d42203729
Playford, E. Diane
51707e0d-5490-4d2f-99cc-cd6297464d61
Clarke, Carl E.
43fb4fd1-46bf-470e-b08d-8ffff4351a53

Deane, Katherine H.O., Ellis-Hill, Caroline, Jones, Diana, Whurr, Renatta, Ben-Shlomo, Yoav, Playford, E. Diane and Clarke, Carl E. (2002) Systematic review of paramedical therapies for Parkinson's disease. Movement Disorders, 17 (5), 984-991. (doi:10.1002/mds.10197).

Record type: Article

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.

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More information

Published date: 2002
Keywords: parkinson's disease, physiotherapy, occupational therapy, speech and language therapy, systematic review

Identifiers

Local EPrints ID: 40758
URI: http://eprints.soton.ac.uk/id/eprint/40758
PURE UUID: d17f2285-1460-45f1-88ef-ef55c498e2e4

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Date deposited: 10 Jul 2006
Last modified: 04 Dec 2018 17:33

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Contributors

Author: Katherine H.O. Deane
Author: Caroline Ellis-Hill
Author: Diana Jones
Author: Renatta Whurr
Author: Yoav Ben-Shlomo
Author: E. Diane Playford
Author: Carl E. Clarke

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