Evidence map›Paper›PMID 22867913›Full record

SynthesisBMJ (Clinical research ed.)2012

Physiotherapy intervention in Parkinson's disease: systematic review and meta-analysis.

Claire L Tomlinson, Smitaa Patel, Charmaine Meek, Clare P Herd, Carl E Clarke, Rebecca Stowe, Laila Shah, Catherine Sackley, Katherine H O Deane, Keith Wheatley and 1 more

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04953637 (Combined Physiotherapy and Deep Brain Stimulation to Improve Independent Community Mobility in Parkinson's Disease), which is not on this map. Cited by 138 papers, 25 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
138citing papers in PubMed, 25 pooled it
–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.

NCT04953637 naactive not recruitingnot on this mapstarted 2021, after this paper: background citation

Combined Physiotherapy and Deep Brain Stimulation to Improve Independent Community Mobility in Parkinson's Disease

TypeinterventionalSponsorUniversity of TorontoRan2021 to 2025Enrolled60ConditionsParkinson DiseaseArmsPhysiotherapy
3 · Its place in the literature

Who cites it

138 citing papers in PubMed, 25 syntheses or guidelines pooled it.

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78 more citing papers are in PubMed but not listed here.

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

11 authors.

Claire L TomlinsonBirmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2TT, UK.
Smitaa Patel
Charmaine Meek
Clare P Herd
Carl E Clarke
Rebecca Stowe
Laila Shah
Catherine Sackley
Katherine H O Deane
Keith Wheatley
Natalie Ives

Funding

Department of Health
6 · The paper itself

Abstract

objectiveTo assess the effectiveness of physiotherapy compared with no intervention in patients with Parkinson's disease.

designSystematic review and meta-analysis of randomised controlled trials. DATA SOURCES: Literature databases, trial registries, journals, abstract books, and conference proceedings, and reference lists, searched up to the end of January 2012. REVIEW

methodsRandomised controlled trials comparing physiotherapy with no intervention in patients with Parkinson's disease were eligible. Two authors independently abstracted data from each trial. Standard meta-analysis methods were used to assess the effectiveness of physiotherapy compared with no intervention. Tests for heterogeneity were used to assess for differences in treatment effect across different physiotherapy interventions used. Outcome measures were gait, functional mobility and balance, falls, clinician rated impairment and disability measures, patient rated quality of life, adverse events, compliance, and economic analysis outcomes.

results39 trials of 1827 participants met the inclusion criteria, of which 29 trials provided data for the meta-analyses. Significant benefit from physiotherapy was reported for nine of 18 outcomes assessed. Outcomes which may be clinically significant were speed (0.04 m/s, 95% confidence interval 0.02 to 0.06, P<0.001), Berg balance scale (3.71 points, 2.30 to 5.11, P<0.001), and scores on the unified Parkinson's disease rating scale (total score -6.15 points, -8.57 to -3.73, P<0.001; activities of daily living subscore -1.36, -2.41 to -0.30, P=0.01; motor subscore -5.01, -6.30 to -3.72, P<0.001). Indirect comparisons of the different physiotherapy interventions found no evidence that the treatment effect differed across the interventions for any outcomes assessed, apart from motor subscores on the unified Parkinson's disease rating scale (in which one trial was found to be the cause of the heterogeneity).

conclusionsPhysiotherapy has short term benefits in Parkinson's disease. A wide range of physiotherapy techniques are currently used to treat Parkinson's disease, with little difference in treatment effects. Large, well designed, randomised controlled trials with improved methodology and reporting are needed to assess the efficacy and cost effectiveness of physiotherapy for treating Parkinson's disease in the longer term.

Indexed as

Activities of Daily LivingPhysical Therapy ModalitiesQuality of LifeDisability EvaluationFemaleGaitHumansMaleMartial ArtsOutcome Assessment, Health CareParkinson DiseaseRandomized Controlled Trials as Topic

Identifiers

PMID22867913
PMCPMC3412755

What OpenQuestion holds

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Read underepoch 390

Registered trials

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 OpenQuestion graph.