Frameworks for Parkinson’s Disease Rehabilitation Addressing When, What, and How

Miriam R. Rafferty*, Ella Nettnin, Jennifer G. Goldman, Jillian MacDonald

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

38 Scopus citations

Abstract

Purpose of Review: This review summarizes the evidence on rehabilitation for people with Parkinson’s disease, including when to refer, what rehabilitation professionals should address, and how to deliver rehabilitation care. Recent Findings: Clinical practice guidelines support physical therapy, occupational therapy, and speech-language pathology for Parkinson’s disease. However, integrating guidelines into practice may be difficult. Implementation studies take into account patient and clinician perspectives. Synthesizing guidelines with implementation research can improve local delivery. Summary: There is moderate to strong evidence supporting physical therapy, occupational therapy, and speech-language pathology soon after diagnosis and in response to functional deficits. We propose a framework of three pathways for rehabilitation care: (1) consultative proactive rehabilitation soon after diagnosis for assessment, treatment of early deficits, and promotion meaningful activities; (2) restorative rehabilitation to promote functional improvements; and (3) skilled maintenance rehabilitation for long-term monitoring of exercise, meaningful activities, safety, contractures, skin integrity, positioning, swallowing, and communication.

Original languageEnglish (US)
Article number12
JournalCurrent neurology and neuroscience reports
Volume21
Issue number3
DOIs
StatePublished - Mar 2021

Funding

Dr. Rafferty reports grants from United States Department of Defense, during the conduct of the study. She reports grants from National Institute on Disability, Independent Living, and Rehabilitation Research; Parkinson’s Foundation; Academy of Neurologic Physical Therapy; Foundation for Physical Therapy; Agency for Healthcare Research and Quality; Davis Phinney Foundation, other from Parkinson’s Foundation, other from Academy of Neurologic Physical Therapy, outside the submitted work. Ella Nettnin has nothing to disclose. Dr. Goldman reports grants from NINDS, MJFF, Parkinson’s Foundation, other from Acadia, Aptinyx, Sunovion, Worldwide Med, grants from CHDI, Biotie, during the conduct of the study. Dr. MacDonald reports grants from Parkinson’s Foundation, grants from Academy of Neurologic Physical Therapy, grants from Department of Defense, outside the submitted work. This work (MR) was supported in part by the Office of the Assistant Secretary of Defense for Health Affairs through the Neurotoxin Exposure Treatment Parkinson’s under Award No. W81XWH-19-PRP-EIRA). Opinions, interpretations, conclusions, and recommendations are those of the author and are not necessarily endorsed by the Department of Defense.

Keywords

  • Healthcare delivery models
  • Occupational therapy
  • Parkinson’s disease
  • Physical therapy
  • Rehabilitation
  • Speech-language pathology

ASJC Scopus subject areas

  • General Neuroscience
  • Clinical Neurology

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