In the course of their disease, most patients with Parkinson's disease (PD) face mounting mobility deficits, including difficulties with transfers, posture, balance, and walking. This frequently leads to loss of independence, (fear of) falls, injuries, and inactivity, resulting in social isolation and an increased risk of osteoporosis or cardiovascular disease.1, 2 Consequently, costs increase3 and quality of life decreases.4 These mobility deficits are difficult to treat with drugs or neurosurgery.5, 6
Physical therapy† is often prescribed next to medical treatment.7 However, there are presently no guidelines for physical therapy in PD with practical recommendations graded according to scientific evidence. Prior research was hampered by this lack of uniform treatment recommendations.8–10 Therefore, we developed evidence-based practice recommendations according to international criteria for guideline development.11, 12 With these recommendations we aim to facilitate the uniformity and efficacy of physical therapy in PD. Furthermore, practice recommendations provide referring physicians insight into the possibilities and limitations of physical therapy in PD, thereby promoting the quality of referrals. Finally, the recommendations can provide a firm basis for future research in this field.
Here, we describe the systematic analysis of evidence and the key recommendations. For detailed recommendations on referral indications and treatment options, we refer to a comprehensive description that is available online: http://www.cebp.nl or http://www.kngf.nl.