Maintaining Strength for Parkinson’s Patients

In an article published in the British Medical Journal, August 23,2012  C.L. Tomlinson  et al state that Physiotherapy has only short term benefits in Parkinson’s disease. He further states that there is a  wide range of physiotherapy techniques  currently in use to treat Parkinson’s disease and that there is little difference in treatment effects. He suggests that there be large, well designed, randomised controlled trials including improved methodology and reporting that are needed to assess the efficacy and cost effectiveness of physiotherapy for the treatment of Parkinson’s disease in the longer term.
The methods used to come to this conclusion were:
A systematic review and analysis of randomised controlled trials.
Literature databases, trial registries,  books, and conference proceedings, journals, and reference lists, searched up to  January 31, 2012.
Randomised controlled trials that compared physiotherapy with no intervention at all in patients with Parkinson’s disease were used.
Two authors independently collected data from each trial.
Tests for heterogeneity were used.
Outcome measures were gait, falls, functional mobility and balance, clinician rated  disability measures, patient rated quality of life, adverse events, compliance, and impairment and economic analysis outcomes.
The results were:
that indirect comparisons of the different physiotherapy interventions found no evidence that the treatment effect was diferent 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).
Apparently C.L. Tomlinson isn’t aware of the TUTOR system. These physical therapy products, although not a cure for Parkinson’s, have shown that they can maintain the strength of the patient thereby giving him a longer period of mobility.
The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR have become a key system in neuromuscular rehabilitation for stroke victims and those recovering from brain and spinal injuries, Parkinson’s, MS, CP and other limb movement limitations. These innovative devices implement an impairment based program with augmented motion feedback that encourages motor learning through intensive active exercises and movement practice. The HANDTUTOR, ARMTUTOR, LEGTUTOR, 3DTUTOR consist of wearable gloves and braces that detect limb movement showing the patient how much active or assisted active movement they are actually doing. The rehabilitation software uses special rehabilitation games to set a new target for this movement in terms of the patient’s ability to move their limb. The devices then measure the limb movement and give feedback on the success of the patient in trying to gain this new movement objective.  In this  way the TUTOR system provides exercises that are challenging and motivating and allow for repetitive and intensive exercise practice. The TUTOR system physical therapy solution is now part of the rehabilitation program of leading U.S. German, Italian, French, UK and other foreign hospitals. As one of the most cost effective PT products on the market the TUTORs can also be used in the patient’s home throughtelerehabilitation. See http://www.MEDITOUCH.CO.IL for more information.

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