Multi-modal rehabilitation therapy in Parkinson's disease and related disorders

Abstract

Long-term use of dopaminergic therapy in Parkinson's disease (PD) is associated with reduction in efficacy and disabling dyskinesias. The current medical or surgical treatment modalities are ineffective for atypical parkinsonism syndromes. Hence, there is a need for holistic and cost-effective non-pharmacological interventions that act via multiple mechanisms to improve motor as well as non-motor symptoms among PD patients. Rehabilitation strategies focusing on multiple mechanisms can lead to improvement in certain symptoms among PD patients, which may be refractory to medical and surgical therapy. However, there is scanty literature available on the role of various rehabilitation strategies in patients with atypical parkinsonism patients. Multiple rehabilitation strategies such physiotherapy, aerobic exercises, strength/resistance exercises, treadmill training, cueing, dance and music, speech language therapy, occupational therapy, hydrotherapy, and martial arts have been found to improve motor as well as non-motor symptoms among PD patients. Newer modalities such as virtual-reality-based devices, exergaming, wearable sensors, and robotic prosthetic devices may be exciting future prospects in rehabilitation among patients with PD and atypical parkinsonian syndromes. This narrative review assessed and summarized the current evidence regarding the role of various rehabilitation strategies in PD and atypical parkinsonian syndromes. Furthermore, evidence regarding recent advancements in rehabilitation for patients with parkinsonism was highlighted. Despite the beneficial effect of rehabilitation in PD, there is still scanty literature available from India on rehabilitation strategies among PD patients. Larger prospective randomized control trials from India and other low- and middle-income countries, focusing on various rehabilitation strategies among PD patients, are an unmet need.

The Evolving Landscape of Parkinson's Disease Research: Current Challenges and Future Outlook

“…Rehabilitation is considered as supplementary to pharmacological and surgical treatments for PD in effort to maximize functional ability and minimize secondary complications. [69][70][71] o Physical therapy can help improve mobility, balance, flexibility, and strength in PD patients. It may also include exercises to address gait abnormalities and freezing of gait.…”

The Evolving Landscape of Parkinson's Disease Research: Current Challenges and Future Outlook

“…Rehabilitation is considered as supplementary to pharmacological and surgical treatments for PD in effort to maximize functional ability and minimize secondary complications. [70][71][72] o Physical therapy can help improve mobility, balance, flexibility, and strength in PD patients. It may also include exercises to address gait abnormalities and freezing of gait.…”

Neuron Foundry Mach 8: A Concept of Multi-modal Neuro-supportive Energy Therapy Device for Treating Neurodegenerative Disorders

“…Medications are commonly used in conventional therapies for neurodegenerative diseases to control symptoms like cognitive decline, tremors, and muscle stiffness [26, 27]. Although these therapies may lessen some of the condition’s symptoms, they do not address the underlying causes of the diseases and may have serious adverse effects [28, 29].…”