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Europa Medicophysica 1998 June;34(2):85-95

Copyright © 1998 EDIZIONI MINERVA MEDICA

language: English

Physical therapy in Parkinson’s disease

Viliani T., Pasquetti P.

Recovery and Functional Rehabilitation Unit, Azienda USL n. 4, Prato, Italy

The man­age­ment of Parkinson’s dis­ease neces­si­tates a mul­ti­dis­ci­pli­nary, glo­bal ­approach, includ­ing phar­mac­o­log­i­cal and non phar­mac­o­log­i­cal treat­ment. Physical ther­a­py ­aimed at lim­it­ing dis­abil­ity and enhanc­ing func­tion­al capac­ities has an impor­tant ­role in the reha­bil­i­ta­tion of ­patients ­with PD. In the ­present lit­er­a­ture ­review, the ­authors dis­cuss the path­o­gen­e­sis of dis­abil­ity in par­kin­so­nian ­patients, and exam­ine the ­most ­recent find­ings on bra­dik­y­ne­sia and ­gait dis­tur­banc­es. Numerous var­i­ables con­trib­ute to the ­kind of dis­abil­ity ­seen in PD ­patients. It is par­tic­u­lar­ly impor­tant to ­explore the rela­tion­ship ­between capac­ity and func­tion­al stat­us in ­order to ­plan appro­pri­ate pro­grammes of phys­i­cal ther­a­py. Gait, bal­ance and man­u­al abil­ity ­seem to be the crit­i­cal fac­tors in main­tain­ing inde­pen­dent liv­ing. In ­their anal­y­sis of the pub­lished reha­bil­i­ta­tion ­research ­data, the ­authors dis­cuss the modal­ities, ­results and effec­tive­ness of phys­i­cal ther­a­py. They out­line its pos­i­tive ­effects on ­gait, bra­dik­y­ne­sia, rigid­ity and trans­fers, and sug­gest guide­lines for for­mu­lat­ing the reha­bil­i­ta­tion pro­gramme. Attention is ­drawn to the ­lack of system­at­ic stud­ies on the spec­i­fic­ity and ­role of ­motor train­ing, and to sev­er­al ­issues ­that ­remain to be ful­ly under­stood. The ­most impor­tant of ­these is wheth­er phys­i­cal ther­a­py can coun­ter­act the neg­a­tive evo­lu­tion of the dis­ease ­toward dis­abil­ity.