Physical Therapy for Freezing of Gait and Gait Impairments in Parkinson Disease: A Systematic Review.

Details

Serval ID
serval:BIB_2869C24D2442
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Physical Therapy for Freezing of Gait and Gait Impairments in Parkinson Disease: A Systematic Review.
Journal
PM & R
Author(s)
Rutz D.G., Benninger D.H.
ISSN
1934-1563 (Electronic)
ISSN-L
1934-1482
Publication state
Published
Issued date
11/2020
Peer-reviewed
Oui
Volume
12
Number
11
Pages
1140-1156
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Freezing of gait (FOG) is a major cause of falls and disability in Parkinson disease (PD). As FOG only partially improves in response to dopaminergic medication, physical therapy is an important element of its management.
To assess the evidence for the physical interventions for FOG and gait impairments and to establish recommendations for clinical practice.
This review follows the guidelines for systematic reviews: the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Systematic search in PubMed, Embase, Physiotherapy Evidence Databases, and CINAHL for randomized controlled trials of PT interventions for FOG in PD patients until April 2018.
Twenty randomized controlled trials (RCTs) were reviewed. In 12 RCTs, PT for FOG was assessed, which was the primary outcome measure in nine of these RCTs. In eight RCTs, PT for gait impairment (not targeting specifically FOG) in PD was assessed. The following PT interventions reduce FOG with a good category A recommendation: cueing strategies (P < .05) (visual and auditory); treadmill walking (P < .05); aquatic obstacle training (P < .01); supervised slackline training (P < .05). These interventions can be combined and maintain their efficacy when being applied concurrently: though there is a lack of long-term follow-up studies. The following PT interventions show possible benefit and need further investigations: balance and coordination training; aquatic gait training; sensory (tactile) cues. The treadmill training and auditory and visual cues are effective also for other gait disturbances in PD and improve gait kinematics.
Visual and auditory cueing and the treadmill training are effective interventions for FOG and gait impairments in PD patients (evidence level A- according to the European Federation of Neurological Societies). Tactile cues and other specific therapies targeting FOG are probably effective but need further studies.
Keywords
Parkinson disease, coordination and balance, cues, freezing of gait, physical therapy, treadmill
Pubmed
Web of science
Create date
31/01/2020 18:01
Last modification date
26/07/2021 16:41
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