Background Physiotherapy is a commonly prescribed intervention for people with Parkinson’s disease (PD). Conventional types of physiotherapy have been studied extensively, while novel modalities are being developed and evaluated. Objective To evaluate the effectiveness of conventional and more recent physiotherapy interventions for people with PD. The meta-analysis performed as part of the 2014 European Physiotherapy Guideline for PD was used as the starting point and updated with the latest evidence. Methods We performed a systematic search in PubMed, CINAHL, Embase, and Web of Science. Randomized controlled trials comparing any physiotherapy intervention with no intervention or sham treatment were included. Trials were classified into 12 categories: conventional physiotherapy, resistance training, treadmill training, strategy training, dance, martial arts, aerobic exercises, hydrotherapy, balance and gait training, dual tasking, exergaming, and Nordic walking. Outcomes included motor symptoms, balance, gait, and quality of life, and are presented as standardized mean differences. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used to systematically appraise methodological quality. Results A total of 191 trials with 7998 participants were included. Conventional physiotherapy significantly improved motor symptoms, gait, and quality of life. Resistance training improved gait. Treadmill training improved gait. Strategy training improved balance and gait. Dance, Nordic walking, balance and gait training, and martial arts improved motor symptoms, balance, and gait. Exergaming improved balance and quality of life. Hydrotherapy improved balance. Finally, dual task training did not significantly improve any of the outcomes studied. Conclusions This meta-analysis provides a comprehensive overview of the evidence for the effectiveness of different physiotherapy interventions in the management of PD, allowing clinicians and patients to make an evidence-based decision for specific treatment modalities. Further work is needed to directly compare the relative efficacy of the various treatments.

中文翻译：

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帕金森病的物理治疗：现有治疗方式的荟萃分析


背景 物理治疗是帕金森病 (PD) 患者的常用干预措施。传统类型的物理治疗已得到广泛研究，同时正在开发和评估新的治疗方式。目的 评估传统和近期物理治疗干预措施对帕金森病患者的有效性。作为 2014 年欧洲 PD 物理治疗指南的一部分进行的荟萃分析被用作起点，并根据最新证据进行了更新。方法 我们在 PubMed、CINAHL、Embase 和 Web of Science 中进行了系统检索。纳入了比较任何物理治疗干预与不干预或假治疗的随机对照试验。试验分为12类：传统物理治疗、阻力训练、跑步机训练、策略训练、舞蹈、武术、有氧运动、水疗、平衡和步态训练、双重任务、运动游戏和越野行走。结果包括运动症状、平衡、步态和生活质量，并以标准化平均差表示。 GRADE（建议、评估、制定和评价分级）方法用于系统地评估方法学质量。结果 共纳入 191 项试验，7998 名受试者。传统的物理治疗显着改善了运动症状、步态和生活质量。阻力训练改善了步态。跑步机训练改善了步态。策略训练改善了平衡和步态。舞蹈、越野行走、平衡和步态训练以及武术改善了运动症状、平衡和步态。运动游戏改善了平衡和生活质量。水疗改善了平衡。最后，双重任务训练并没有显着改善任何研究结果。 结论 这项荟萃分析全面概述了不同物理治疗干预措施在 PD 治疗中的有效性证据，使临床医生和患者能够针对具体的治疗方式做出基于证据的决定。需要进一步的工作来直接比较各种治疗方法的相对疗效。