Evidence map›Paper›PMID 34366377›Full record

SynthesisJournal of Parkinson's disease2021

Effectiveness of Long-Term Physiotherapy in Parkinson's Disease: A Systematic Review and Meta-Analysis.

Yohei Okada, Hiroyuki Ohtsuka, Noriyuki Kamata, Satoshi Yamamoto, Makoto Sawada, Junji Nakamura, Masayuki Okamoto, Masaru Narita, Yasutaka Nikaido, Hideyuki Urakami and 4 more

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of Parkinson's disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 5 pooled it
5.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 5 syntheses or guidelines pooled it, 61 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 8 institutions in 1 country.

Yohei OkadaGraduate School of Health Sciences, Kio University, Nara, Japan.
Hiroyuki OhtsukaDepartment of Physical Therapy, Showa University School of Nursing and Rehabilitation Sciences, Kanagawa, Japan.
Noriyuki KamataDepartment of Rehabilitation, Osaka University Hospital, Osaka, Japan.
Satoshi YamamotoDepartment of Physical Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan.
Makoto SawadaDepartment of Rehabilitation Medicine, National Hospital Organization Tottori Medical Center, Tottori, Japan.
Junji NakamuraGraduate School of Health Sciences, Kio University, Nara, Japan.
Masayuki OkamotoDepartment of Rehabilitation Medicine, Kakita Hospital, Kyoto, Japan.
Masaru NaritaGraduate School of Health Sciences, Kio University, Nara, Japan.
Yasutaka NikaidoDepartment of Rehabilitation, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan.
Hideyuki UrakamiDepartment of Rehabilitation, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan.
Tsubasa KawasakiDepartment of Physical Therapy, School of Health Sciences, Tokyo International University, Saitama, Japan.
Shu MoriokaGraduate School of Health Sciences, Kio University, Nara, Japan.
Koji ShomotoGraduate School of Health Sciences, Kio University, Nara, Japan.
Nobutaka HattoriDepartment of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Kio University · JPIbaraki Prefectural University of Health Sciences · JPJuntendo University · JPOsaka University Hospital · JPShowa University · JPTaoka Hospital · JPTokyo International University · JPTottori University Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLong-term physiotherapy is acknowledged to be crucial to manage motor symptoms for Parkinson's disease (PD) patients, but its effectiveness is not well understood.

objectiveThis systematic review and meta-analysis aimed to assess the evidence regarding the effectiveness of long-term physiotherapy to improve motor symptoms and reduce antiparkinsonian medication dose in PD patients.

methodsPubmed, Cochrane, PEDro, and CINAHL were searched for randomized controlled trials before August 31, 2020 that investigated the effectiveness of physiotherapy for 6 months or longer on motor symptoms and levodopa-equivalent dose (LED) in PD patients with Hoehn and Yahr stage 1- 3. We performed random effects meta-analyses for long-term physiotherapy versus no/control intervention and estimated standard mean differences with 95% confidence intervals (CIs). Levels of evidence were rated by the Grading of Recommendation Assessment, Development and Evaluation approach.

resultsFrom 2,940 studies, 10 studies involving 663 PD patients were assessed. Long-term physiotherapy had favorable effects on motor symptoms in off medication state [- 0.65, 95% CI - 1.04 to - 0.26, p = 0.001] and LED [- 0.49, 95% CI - 0.89to - 0.09, p = 0.02]. Subgroup analyses demonstrated favorable effects on motor symptoms in off medication state by aerobic exercise [- 0.42, 95% CI - 0.64 to - 0.20, p < 0.001] and LED by multidisciplinary rehabilitation of primarily physiotherapy [- 1.00, 95% CI - 1.44 to - 0.56, p < 0.001]. Quality of evidence for aerobic exercise and multidisciplinary rehabilitation were low and very low.

conclusionThis review provided evidence that long-term physiotherapy has beneficial impact on motor symptoms and antiparkinsonian medication dose in PD patients and could motivate implementation of long-term physiotherapy.

Indexed as

Parkinson DiseaseAntiparkinson AgentsHumansLevodopaPhysical Therapy ModalitiesAntiparkinson AgentsLevodopameta-analysismotor symptomsParkinson’s diseasePhysiotherapyrandomized controlled trialsystematic review

Identifiers

PMID34366377
PMCPMC8609713
OpenAlexW3187410266

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.