Rehabilitative therapy in patients with Parkinson's disease

Long-term complications of Parkinson's disease (PD) include impairments of speech, swallowing, limb function, gait, balance, and activities of daily living. Even with optimal medical management (pharmacological, surgical) these deficits cannot be controlled satisfactorily in the vast majority of patients and have a negative impact on quality of life [1] and [2]. Rehabilitative therapy including physiotherapy, speech training, and occupational therapy is often administered on empirical grounds to counteract the progressive pharmaco-resistant motor disturbances. Studies meeting high methodological standards have been published on this field in recent years, moving rehabilitative therapy toward a more evidence-based approach. In addition, basic science research in animal models of PD has documented the value of exercise for improving motor performance and potentially slowing progression of motor symptoms and neural degeneration [3]. Collectively, these findings have accentuated the important role of exercise and rehabilitation in the management of PD.