Identifying optimal timing of physical therapy to mitigate Parkinson’s symptoms

By Todd Taylor

Physical therapy is a common treatment for people with Parkinson’s disease to help mitigate progressive symptoms that affect mobility, posture, balance and walking, but the ideal timing of physical therapy sessions is an ongoing point of discussion. A new JAMA Neurology viewpoint article explores this topic, providing insight and posing questions about how to optimize physical therapy.

Drs. Michael Okun and Ramzi Salloum

The article is authored by Ramzi Salloum, Ph.D., an associate professor in UF’s department of health outcomes and biomedical informatics; Michael Okun, M.D., chair of UF neurology; and Kelvin Au, M.D., a former movement disorders fellow at the Norman Fixel Institute for Neurological Diseases at UF Health and a clinical assistant professor at the University of Kansas Medical Center.

While a recent study co-authored by Okun and Au reported that spaced out physical therapy over six months was more beneficial than the conventional approach of intensive burst physical therapy conducted over six weeks, the viewpoint authors argue that larger, more diverse trials with a longer duration are needed. They also point to other considerations for the best therapy approach, such as insurance coverage and participation barriers.

“We strongly urge more comparative effectiveness research into the timing of physical therapy delivery in Parkinson’s disease,” the authors wrote. “The time has come to develop the evidence-base and to align stakeholder incentives in a serious effort to move the needle toward better Parkinson’s disease outcomes.”

Read the paper in JAMA Neurology.