A Systematic Review of Physical Therapy Interventions for Parkinson’s Disease

Abstract Purpose: The purpose of this systematic review is to identify effective interventions applied by physical therapists to address common impairments in patients with Parkinson’s Disease(PD). Methods: A search of Pubmed, Medline, Scopus, Wiley Online Library, EbscoHost, CINHAHL were used to identify studies published from 2007 to 2017 written in English with the key words: Parkinson’s Disease, posture, balance, gait, rigidity. Results: 25 studies published between 2007 to 2017 that met the inclusion criteria were used. Based on the quality level of evidence, 13 of the studies were qualified as IB, two as IIB, and 10 as III. To address posture, using a hyperextension brace while performing strengthening exercises for 30 minutes a day for four months, strengthening while wearing a weighted backpack twice a day for five weeks, or a multiple intervention approach that incorporates functional strengthening for five days a week in a four week period can be beneficial. Usage of an UpRight device for 21 consecutive days or kinesio tape with postural rehabilitation in 12 visits over four weeks can be incorporated. Use of aquatic rehabilitation can be used to treat abnormal flexion when completing five sessions per week for a total of eight weeks. To address rigidity, Yoga can be beneficial when performed two times a week for 12 weeks. Interval training three times a week for eight weeks can decrease rigidity. Treatments for gait include LVST BIG four times per week for four weeks. A curved walking program for 12 sessions over four to six weeks can increase gait speed. Auditory cueing during the first month of gait training and progressive resistance training can be incorporated two times a week for 10 weeks. Such improvements include decreasing freezing of gait, increased stride length, and speed of movement. To address balance impairments, Tai Chi can be done for two to three times a week for 60 minutes, dance therapy for 75 minutes, Adaptive Tango twice a week, or Argentine Tango can be performed five times a week. Repetitive step training three times a week or HiBalance training three times a week can improve balance. Conclusion: This review indicates that multiple approaches can be used to treat common impairments such as posture abnormalities, rigidity, balance and gait deficits seen in patients with PD. Keywords: Posture, Balance, Parkinson’s Disease, Gait, Rigidity