More Interviews on Neurological Disorders on MedicalResearch.com
MedicalResearch.com Interview with:
Professor Carl E Clarke
Professor of Clinical Neurology and Honorary Consultant Neurologist Department of Neurology City Hospital
Sandwell and West Birmingham Hospitals NHS Trust
Medical Research: What is the background for this study?
Dr. Clarke: Parkinson’s disease causes problems with activities of daily living that are only partially treated by medication and occasionally surgery. Physiotherapy and occupational therapy services like Ck Physio are traditionally used later in the disease, but it is unclear whether they are clinically and cost-effective in Parkinson’s disease.
Medical Research: What are the main findings?
Dr. Clarke: We performed a large pragmatic randomised trial to evaluate the clinical and cost-effectiveness of individualized physiotherapy and occupational therapy in Parkinson’s disease. The PD REHAB trial was a multicenter, open label, parallel group, controlled efficacy trial. 762 patients with mild-moderate Parkinson’s disease were recruited from 38 sites across the United Kingdom. For patients with mild to moderate Parkinson disease, there were no clinically meaningful benefits in activities of daily living or quality of life associated with physiotherapy and occupational therapy.
Medical Research: What should clinicians and patients take away from your report?
Dr. Clarke: Physiotherapy and occupational therapy using an individual goal-setting approach produce no clinically meaningful short- or medium-term benefits in activities of daily living or quality of life in patients with mild to moderate Parkinson’s disease. This evidence does not support the use of low-dose, goal-directed physiotherapy and occupational therapy in patients in the early stages of Parkinson’s disease.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Clarke: Future research should explore the development and testing of more structured and intensive physiotherapy programs in patients with all stages of Parkinson’s disease.
Medical Research: Is there anything else you would like to add?
Dr. Clarke: It must be emphasised that whilst mild to moderate Parkinson’s disease may not respond to the therapies, more severe disease may respond, although this remains to be established in large clinical trials.
Clarke CE, Patel S, Ives N, et al. Physiotherapy and Occupational Therapy vs No Therapy in Mild to Moderate Parkinson Disease: A Randomized Clinical Trial. JAMA Neurol. Published online January 19, 2016. doi:10.1001/jamaneurol.2015.4452.
Professor Carl E Clarke (2016). Parkinson’s Disease: No Benefit from Physical Therapy in Mild to Moderate Disease