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Comment & Response |

Physiotherapy and Occupational Therapy and Mild to Moderate Parkinson Disease

Régis Gemerasca Mestriner, PT, PhD1
[+] Author Affiliations
1Pontifical Catholic University of Rio Grande do Sul, Nursing, Nutrition, and Physiotherapy College, Porto Alegre, Rio Grande do Sul, Brazil
JAMA Neurol. 2016;73(7):894. doi:10.1001/jamaneurol.2016.1280.
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To the Editor I read with interest the article by Clarke et al.1 They provide an interesting randomized clinical trial showing physiotherapy (PT) and occupational therapy (OT) are not associated with immediate or medium-term clinically significant improvements in activities of daily living or quality of life in mild to moderate Parkinson disease (PD). Low doses of PT and OT were delivered in the community or outpatient setting by therapists working within the UK National Health Service per local practice. During 8 weeks of treatment, patients received a median of 4 therapy sessions (mean of 58 minutes each); the mean total dose of both therapies was 263 minutes. Considering 8 weeks have 56 days, the mean of delivered therapy was only 4.69 minutes of both therapies per day. It may be classified, optimistically, as a low dose or, realistically, as an impressive PT/OT treatment nonadherence.


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July 1, 2016
Terry Ellis, PhD, PT, NCS; Linda Tickle-Degnen, PhD, OTR/L; Marie Saint-Hilaire, MD, FRCPC
1Center for Neurorehabilitation, Department of Physical Therapy, Boston University, Boston, Massachusetts
2Collaborative Learning & Innovation Complex, Department of Occupational Therapy, Tufts University, Medford, Massachusetts
3Department of Neurology, Boston University School of Medicine, Boston, Massachusetts4Parkinson Disease and Movement Disorders Program, Boston Medical Center, Boston, Massachusetts
JAMA Neurol. 2016;73(7):892-893. doi:10.1001/jamaneurol.2016.1274.
July 1, 2016
Nienke M. de Vries, PhD; Ingrid H. Sturkenboom, PhD; Bastiaan R. Bloem, MD, PhD
1Department of Neurology, Donders Centre for Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
2Department of Rehabilitation, Donders Centre for Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
JAMA Neurol. 2016;73(7):893-894. doi:10.1001/jamaneurol.2016.1277.
July 1, 2016
Carl E. Clarke, MD; Marion F. Walker, PhD; Catherine M. Sackley, PhD
1School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, England2Department of Neurology, Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham, England
3University of Nottingham, Nottingham, England
4King’s College London, London, England
JAMA Neurol. 2016;73(7):894-895. doi:10.1001/jamaneurol.2016.1283.
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