Evidence map›Paper›PMID 40211348›Full record

SynthesisJournal of neuroengineering and rehabilitation2025

Is physical therapy recommended for people with parkinson's disease treated with subthalamic deep brain stimulation? a delphi consensus study.

Matteo Guidetti, Sara Marceglia, Tommaso Bocci, Ryan Duncan, Alfonso Fasano, Kelly D Foote, Clement Hamani, Joachim K Krauss, Andrea A Kühn, Francesco Lena and 14 more

Abstract readSystematic ReviewConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of neuroengineering and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

24 authors.

Matteo GuidettiAldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142, Milan, MI, Italy.
Sara MarcegliaAldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142, Milan, MI, Italy. sara.marceglia@unimi.it.
Tommaso BocciAldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142, Milan, MI, Italy.
Ryan DuncanSchool of Medicine, Program in Physical Therapy, Washington University in St. Louis, St. Louis, MO, USA.
Alfonso FasanoKrembil Research Institute, University Health Network, Toronto, ON, Canada.
Kelly D FooteDepartment of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, 3011 SW Williston Rd, Gainesville, FL, 32608, USA.
Clement HamaniSunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
Joachim K KraussDepartment of Neurosurgery, Hannover Medical School, Hannover, Germany.
Andrea A KühnDepartment of Neurosurgery, Hannover Medical School, Hannover, Germany.
Francesco LenaDepartment of Medicine and Health, University of Molise, 86100, Campobasso, Italy.
Patricia LimousinDepartment of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology and the National Hospital for Neurology and Neurosurgery, London, UK.
Andres M LozanoKrembil Research Institute, University Health Network, Toronto, ON, Canada.
Natale V MaioranaAldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142, Milan, MI, Italy.
Nicola ModugnoIRCCS INM Neuromed, 86077, Pozzilli, Italy.
Elena MoroDivision of Neurology, CHU of Grenoble, Grenoble Institute of Neurosciences, INSERM U1216, Grenoble Alpes University, Grenoble, France.
Michael S OkunDepartment of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, USA.
Serena OliveriAldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142, Milan, MI, Italy.
Marco SantilliIRCCS INM Neuromed, 86077, Pozzilli, Italy.
Alfons SchnitzlerInstitute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
Yasin TemelDepartment of Neurosurgery, Maastricht University Medical Center, Maastricht, Netherlands.
Lars TimmermannDepartment of Neurology, University Hospital of Marburg, Marburg, Germany.
Veerle Visser-VandewalleDepartment of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Jens VolkmannDepartment of Neurology, University Hospital Würzburg, Würzburg, Germany.
Alberto PrioriAldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142, Milan, MI, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough deep brain stimulation of the subthalamic nucleus (STN-DBS) induces motor benefits in people with Parkinson's disease (PwPD), its effect on motor axial symptoms (e.g., postural instability, trunk posture alterations) and gait impairments (e.g., freezing of gait) is still ambiguous. Physical therapy (PT) effectively complements pharmacological treatment to improve postural stability, gait performance, and other dopamine-resistant symptoms (e.g. freezing of gait) in the general population with PD. Despite the positive potential of combined PT and STN-DBS surgery, scientific results are still lacking. We therefore involved worldwide leading experts on DBS and motor rehabilitation in PwPD in a consensus Delphi panel to define the current level of PT recommendation following STN-DBS surgery.

methodsAfter summarizing the few available findings through a systematic scoping review, we identified clinically and academically experienced DBS clinicians (n = 21) to discuss the challenges related to PT following STN-DBS. A 5-point Likert scale questionnaire was used and based on the results of the systematic review, thirty-nine questions were designed and submitted to the panel-half related to general considerations on PT following STN-DBS, and half related to PT treatments.

resultsDespite the low-to-moderate quality of data, the few available rehabilitation studies suggested that PT could improve dynamic and static balance, gait performance and posture in the population with PD receiving STN-DBS. Similarly, the panellists strongly agreed that PT might help improve motor symptoms and quality of life, and it may be prescribed to maximize the effects of stimulation. The experts agreed that physical therapists could be part of the multidisciplinary team taking care of the patients. Also, they agreed that conventional PT, but not massage or manual therapy, should be prescribed because of the specificity of STN-DBS implantation.

conclusionsAlthough RCT evidence is lacking, upon Delphi panel, PT for PwPD receiving STN-DBS can be potentially useful to maximize clinical improvement. However, more research is needed, with RCTs and well-designed studies. The rehabilitation and DBS community should expand this area of research to create guidelines for PT following STN-DBS.

Indexed as

Deep Brain StimulationParkinson DiseasePhysical Therapy ModalitiesSubthalamic NucleusDelphi TechniqueHumansDBSDeep brain stimulationDelphi consensusMotor rehabilitationMovement disordersNeuromodulationParkinson’s diseasePhysical therapyPhysiotherapy

Identifiers

PMID40211348
PMCPMC11987424

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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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.