The Role of Architecture and Design in the Management of Parkinson’s Disease: A Systematic Review

Abstract

Background: Parkinson’s disease (PD) is a neurological condition characterized by the development of daily disabling symptoms. Although the architecture and design of a PD patient’s environment can hinder or facilitate full participation in daily activities, their putative role in the management of these patients has received little attention to date. Objective: We conducted a systematic review to evaluate the evidence of architectural and design features in the management of people with PD. Methods: An electronic database search of observational and experimental studies was conducted in MEDLINE and Embase from inception to May 2020, with two independent reviewers identifying the studies. Falls, fear of falling, postural instability, gait impairment/disability, and functional mobility were our outcomes of interest. Results: Thirty-six studies were included, among which nineteen were observational and seventeen were experimental studies (overall participants = 2,965). Pavement characteristics, notably unstable surfaces and level differences, were found to be a major cause of falling. Ground-based obstacles and confined/narrowed spaces were found to disturb gait, increase postural instability, and decrease functional mobility. Housing type did not appear to increase risk of falling, nor to significantly explain concerns about falling. Conclusion: Findings suggest a need to adjust architectural features of the surrounding space to ensure appropriate care and provide a safe environment to PD patients. More evidence about the impact of such modifications on PD outcomes is needed.

People with Parkinson's disease and housing issues: A scoping review

“…Published shortly after the search period for our review, a systematic review of the role of architecture and design in the management of PD caught our interest. 38 In that context the built and natural environment dimension seems to be more prominent than in the publications with a specific focus on housing included in the present review. Ramos et al show that design features such as pavement characteristics in terms of unstable surfaces and level differences are major causes of falling.…”

“…Going beyond the specific focus on housing, there is PD research focusing on the built and natural environment dimension in a broader sense, which was out of the scope of the present study. Published shortly after the search period for our review, a systematic review of the role of architecture and design in the management of PD caught our interest 38 . In that context the built and natural environment dimension seems to be more prominent than in the publications with a specific focus on housing included in the present review.…”

Determinants of patient reported functional mobility in people with Parkinson's disease: a systematic review.

“…Moreover, our results strengthen their hypothesis that the environmental factors (ability to drive [22], caregiving [22]), the personal factors (sex [22], age [6,22]), the body function (cognitive impairment [6], postural instability [6]), and "social participation" [22] are determinants of patient-reported functional mobility. Furthermore, according to the recent review of Ramos, et al [35], architecture and design (e.g., housing adaptations/accessibility/usability, floor surface/lights/signaled pedestrian crossings or reaching/space between objects) are associated with functional mobility. However, the included studies of that review applied qualitative study designs [36,37] or did not assess patient-reported functional mobility [38].…”

Construction for Health; Reversing the Impacts

“…Secondly, most of the conducted studies concentrate on disabilities and problematic areas, such as the built environment for vulnerable members of society or people with particular diseases such as Alzheimer's, Parkinson's, and dementia (e.g., Refs. [66,[115][116][117][118][119][120][121][122][123][124][125][126]). Yet, the impacts of conventional construction systems (CCSs) and conventional construction materials (CCMs) on health (i.e., physical and mental WB) are rarely discussed.…”