Erin R. Foster, Mayuri Bedekar, Linda Tickle-Degnen; Systematic Review of the Effectiveness of Occupational Therapy–Related Interventions for People With Parkinson’s Disease. Am J Occup Ther 2014;68(1):39–49. https://doi.org/10.5014/ajot.2014.008706
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© 2019 American Occupational Therapy Association
We describe the results of a systematic review of the literature on occupational therapy–related interventions for people with Parkinson’s disease (PD). Three broad categories of intervention emerged: (1) exercise or physical activity; (2) environmental cues, stimuli, and objects; and (3) self-management and cognitive–behavioral strategies. Moderate to strong evidence exists for task-specific benefits of targeted physical activity training on motor performance, postural stability, and balance. Low to moderate evidence indicates that more complex, multimodal activity training supports improvement in functional movement activities. The evidence is moderate that the use of external supports during functional mobility or other movement activities has positive effects on motor control. In addition, moderate evidence is available that individualized interventions focused on promoting participant wellness initiatives and personal control by means of cognitive–behavioral strategies can improve targeted areas of quality of life. The implications for practice, education, and research are discussed.
Occupational therapy practitioners should encourage their clients with PD to engage in regular physical activity and can help them find appropriate and meaningful forms of physical activity to ensure continued engagement. More complex, multimodal forms of exercise with an interpersonal component may confer the broadest benefits.
Practitioners can recommend a system of targeted external cues or supports that people with PD and their caregivers can implement to regulate physical performance during daily activities. A substantial amount of training and practice on the use of these supports would likely be necessary, and the long-term effects should be monitored because they are currently unknown.
Practitioners should consider the impact of PD-related nonmotor dysfunction (e.g., cognitive impairment, depression) on occupational performance and participation.
Practitioners should incorporate client-centered self-management strategies into intervention with clients with PD to enhance self-efficacy and maintain participation in valued activities and roles, thus mitigating the negative effects of PD on health and quality of life.
Practitioners can refine interventions from the aging or chronic neurological disease literature for people with PD. Examples of intervention approaches that seem particularly relevant are home modifications and fatigue management programs.
Although individually tailored treatments in clients’ natural environments are important for addressing daily function and independence, social support gained from being in a group setting with other people living with PD is likely beneficial for social participation and overall quality of life. Practitioners can guide their clients with PD toward community resources for this type of social interaction (e.g., programs provided by the American Parkinson Disease Association).
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