Striding Out With Parkinson Disease: Evidence-Based Physical Therapy for Gait Disorders

• Published in: Physical therapy Vol. 90; no. 2; pp. 280 - 288
• Main Authors: Morris, Meg E, Martin, Clarissa L, Schenkman, Margaret L
• Format: Journal Article
• Language: English
• Published: United States American Physical Therapy Association 01.02.2010; Oxford University Press
• Subjects: Care and treatment; Complications and side effects; Data collection; Development and progression; Evidence-based medicine; Evidence-Based Practice; Gait; Gait disorders; Gait Disorders, Neurologic - etiology; Gait Disorders, Neurologic - rehabilitation; Humans; Jacquelin Perry Special Issue: Stepping Forward With Gait Rehabilitation; Methods; Older people; Parkinson disease; Parkinson Disease - complications; Parkinson Disease - physiopathology; Parkinson Disease - rehabilitation; Parkinson's disease; Physical therapy; Physical Therapy Modalities; Postural Balance; Randomized Controlled Trials as Topic; Studies; Therapeutics, Physiological; Walking; United States
• ISSN: 0031-9023; 1538-6724
• DOI: 10.2522/ptj.20090091

Although Parkinson disease (PD) is common throughout the world, the evidence for physical therapy interventions that enable long-term improvement in walking is still emerging. This article critiques the major physical therapy approaches related to gait rehabilitation in people with PD: compensatory strategies, motor skill learning, management of secondary sequelae, and education to optimize physical activity and reduce falls. The emphasis of this review is on gait specifically, although balance and falls are of direct importance to gait and are addressed in that context. Although the researchers who have provided the evidence for these approaches grounded their studies on different theoretical paradigms, each approach is argued to have a valid place in the comprehensive management of PD generally and of gait in particular. The optimal mix of interventions for each individual varies according to the stage of disease progression and the patient's preferred form of exercise, capacity for learning, and age.