Delivering Multidisciplinary Rehabilitation Care in Parkinson’s Disease: An International Consensus Statement

Abstract

Background: Parkinson’s disease (PD) is a complex neurodegenerative disorder impacting everyday function and quality of life. Rehabilitation plays a crucial role in improving symptoms, function, and quality of life and reducing disability, particularly given the lack of disease-modifying agents and limitations of medications and surgical therapies. However, rehabilitative care is under-recognized and under-utilized in PD and often only utilized in later disease stages, despite research and guidelines demonstrating its positive effects. Currently, there is a lack of consensus regarding fundamental topics related to rehabilitative services in PD. Objective: The goal of the international Parkinson’s Foundation Rehabilitation Medicine Task Force was to develop a consensus statement regarding the incorporation of rehabilitation in PD care. Methods: The Task Force, comprised of international multidisciplinary experts in PD and rehabilitation and people directly affected by PD, met virtually to discuss topics such as rehabilitative services, existing therapy guidelines and rehabilitation literature in PD, and gaps and needs. A systematic, interactive, and iterative process was used to develop consensus-based statements on core components of PD rehabilitation and discipline-specific interventions. Results: The expert-based consensus statement outlines key tenets of rehabilitative care including its multidisciplinary approach and discipline-specific guidance for occupational therapy, physical therapy, speech language pathology/therapy, and psychology/neuropsychology across all PD stages. Conclusions: Rehabilitative interventions should be an essential component in the comprehensive treatment of PD, from diagnosis to advanced disease. Greater education and awareness of the benefits of rehabilitative services for people with PD and their care partners, and further evidence-based and scientific study are encouraged.

Cognitive Impairments in Parkinson’s Disease: Professional Support and Unmet Rehabilitation Needs in Patients with and without Self-Reported Cognitive Impairments—A Secondary Analysis

“…It is stated, that in PD, cognitive and everyday functioning should be assessed and appropriate interventions initiated [33]. This is supported by a Global Consensus of Rehabilitation in PD, published in 2024 [8].…”

“…There is no medical cure for Parkinson's disease, and efforts that may improve quality of life and functional capacity in everyday life are therefore central to the management of the disease [1,3]. Efforts should include interventions targeting both motor and non-motor symptoms in general, as well as more specific problems caused by cognitive impairments [1,[5][6][7][8].…”

Effects and Mechanisms of Exercise on Brain-Derived Neurotrophic Factor (BDNF) Levels and Clinical Outcomes in People with Parkinson’s Disease: A Systematic Review and Meta-Analysis

“…Personalized exercise programs are feasible, accessible, and safe, as shown by Harpham et al [ 96 ] in a high-intensity interval training protocol in the home environment. A recent study [ 97 ] conducted by experts in multidisciplinary rehabilitation and PD found rehabilitation to be underutilized especially in early-stage PD and defined key principles for rehabilitative care. This, combined with our findings, could lead to PD treatment strategies shifting from more medication-focused towards exercise-focused, and we could see personalized exercise regiments becoming a more valuable tool for combating motor symptoms, especially in early PD.…”