Effectiveness of Physiotherapy Interventions for Patients With Parkinson's Disease
Effectiveness of Physiotherapy Interventions for Patients With Parkinson's Disease
Parkinson's Disease is an incurable and progressive disease. Treatment includes medication
 and non-pharmacological intervention such as physiotherapy. Physiotherapy is a main component
 of non-pharmacological interventions. It includes exercise to strengthen the muscles;
 improves balance and walking, and adopts the use of visual cue training. Treatment has been
 found to be effective in patients with mild impairment up to 6 months post-treatment. The
 present study will investigate the effectiveness of treatment for patients with mild to
 moderate impairment for short term (3-month) and long term (1 year). The hypothesis is that
 compared to patient education alone, physiotherapy intervention for patients with Parkinson's
 disease leads to improve function and quality of life.
Parkinson's disease (PD) is an incurable and progressive disease (Rubenis 2007). Current
 management include medical, neuro-surgical and non-pharmacological intervention.
 Physiotherapy is a major component in non-pharmacological interventions. Effective
 interventions including visual or auditory cues improves gait (Nieuwboer et al. 2007),
 exercise is effective in improving balance (Hirsch et al 2003); intense treadmill training
 improves motor control, quality of life and walking speed so as to sustain improvement in
 gait speed and motor control post 4 weeks of treatment (Herman et al 2007). Patient with PD
 attending physiotherapy twice weekly, one and half hour for 12 weeks showed improvement in
 walking speed and Activities of Daily Living (Ellis et al 2005). However, the majority of
 focus on patients in the Hoehn and Yahr stage of 2 to 3 and long term effect is lacking
 (Kwakkel et al 2007). A knowledge gap is present in the effectiveness of physiotherapy
 training of patients with Parkinson's disease in the more advanced stage of disease and long
 term effect is lacking. The aim of the study is to investigate the immediate, short-term &
 long-term clinical effects of physiotherapy training of patients with Parkinson's disease.
 The hypothesis is that compared to patient education alone, physiotherapy intervention for
 patients with Parkinson's disease leads to improve function and quality of life.
Inclusion Criteria:

 -  Stable medication usage

 -  Hoehn and Yahr stage II to IV

 -  At least 1 score of 2 or more for at least 1 limb of either the tremor, rigidity, or
 bradykinesia item of the Unified Parkinson's Disease Rating Scale (UPDRS)

 -  Able to walk independently

 -  No severe cognitive impairments (Mini-Mental State Examination - Chinese Cantonese
 version) score greater than 24

 Exclusion Criteria:

 -  Other severe neurological, cardiopulmonary, or orthopedic disorders

 -  Having participated in a physiotherapy or rehabilitation program in previous 2 months