A Cochrane review [Abstract] 1 included 39 studies with a total of 1827 subjects with Parkinson's disease. The mean age was 67 years, and they had had Parkinson's disease for approximately six years . The assessment period ranged from 3 weeks to 12 months. Compared with no-intervention, physiotherapy significantly improved the gait outcomes of velocity (MD 0.04 m/s, 95% CI: 0.02 to 0.06; 15 trials, n=814), 2- or 6-minute walk test (13.37 m, CI: 1.90 to 30.90; 6 trials, n=242), Freezing of Gait questionnaire (-1.41, 95% CI -2.63 to -0.19, 4 trials, n=298); functional mobility and balance outcomes of Timed Up & Go test (-0.63 s, 95% CI -1.05 to -0.21, 9 trials, n=639), Functional Reach Test (2.16 cm, 95% CI 0.89 to 3.43, 4 trials, n=393), and Berg Balance Scale (3.71 points, 95% CI 2.30 to 5.11, 5 trials, n=385); and clinician-rated disability using the Unified Parkinson's Disease Rating Scale (UPDRS) (total -6.15 points, 95% CI -8.57 to -3.73; 3 trials, n=207; activities of daily living: -1.36, 95% CI -2.41 to -0.30; 3 trials, n=157; and motor: -5.01, 95% CI -6.30 to -3.72; 12 trials, n=593). No difference between arms was noted in falls (Falls Efficacy Scale: -1.91 points, 95% CI -4.76 to 0.94; 4 trials, n=353) or patient-rated quality of life (PDQ-39 Summary Index: -0.38 points, 95% CI -2.58 to 1.81; 7 trials, n=405). Indirect comparisons of the different physiotherapy interventions revealed no evidence that the treatment effect differed across physiotherapy interventions for any of the outcomes assessed.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment, short follow-up time).
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