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Evaluation and delivery of ambulatory rehabilitation for people with Parkinson's disease

Published online by Cambridge University Press:  24 January 2014

Leah S Goodwin  and
Ling Lan
Leah S Goodwin
Affiliation:
Geriatric and Rehabilitation Department, The Prince Charles Hospital, Queensland, Australia
Ling Lan*
Affiliation:
Geriatric and Rehabilitation Department, The Prince Charles Hospital, Queensland, Australia
*
Address for correspondence: Ling Lan, Rehabilitation Physician/Senior Lecturer, Geriatric and Rehabilitation Department, The Prince Charles Hospital, Queensland, 4053, Australia. Email: [email protected]
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Summary

Parkinson's disease (PD) is a common and costly condition affecting a predominantly older population. Physical rehabilitation has been shown to enhance motor performance and functional mobility in the short-term. However, there is limited information available about how best to design and deliver an ambulatory rehabilitation (AR) programme for this patient group. This article reviews the current evidence, aiming to provide guidance about best-practice service provision. We highlight the benefits of group therapy and techniques aimed at reducing falls. Further research is required to determine the optimal dose and intensity of AR necessary to provide sustained benefits in people with different stages of PD.

Keywords

Parkinson's diseaseexercise therapyrehabilitationambulatory careaccidental falls
Type
Review Article
Information
Reviews in Clinical Gerontology , Volume 24 , Issue 2 , May 2014 , pp. 122 - 138
Copyright
Copyright © Cambridge University Press 2014 

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References

1Sidaway, B, Anderson, J, Danielson, G, Martin, L, Smith, G. Effects of long-term gait training using visual cues in an individual with Parkinson disease. Phys Ther 2006; 86: 186–94.Google Scholar
2Rosenthal, LS, Dorsey, ER. The benefits of exercise in Parkinson disease. JAMA Neurology 2013; 70: 156–57.Google Scholar
3States, RA, Spierer, DK, Salem, Y. Long-term group exercise for people with Parkinson's disease: a feasibility study. J Neurol Phys Ther 2011; 35: 122–28.Google Scholar
4Hirtz, D, Thurman, DJ, Gwinn-Hardy, K, Mohamed, M, Chaudhuri, AR, Zalutsky, R. How common are the ‘common’ neurologic disorders? Neurology 2007; 68: 326–37.Google Scholar
5Dorsey, ER, Constantinescu, R, Thompson, JPet al.Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology 2007; 68: 384–86.Google Scholar
6Whetten-Goldstein, K, Sloan, F, Kulas, E, Cutson, T, Schenkman, M. The burden of Parkinson's disease on society, family, and the individual. J Am Geriatr Soc 1997; 45: 844–49.Google Scholar
7Living with Parkinson's disease – update 2011. Report for Parkinson's Australia; available at: https://www.deloitteaccesseconomics.com.au/uploads/File/2011%20Living%20with%20Parkinsons%20Disease%20FINAL.PDF (accessed 17 August 2013).Google Scholar
8von Campenhausen, S, Winter, Y, Rodrigues e Silva, Aet al.Costs of illness and care in Parkinson's disease: an evaluation in six countries. Eur Neuropsychopharmacol 2011; 21: 180–91.CrossRefGoogle ScholarPubMed
9Spottke, AE, Reuter, M, Machat, Oet al.Cost of illness and its predictors for Parkinson's disease in Germany. Pharmacoeconomics 2005; 23: 817–36.Google Scholar
10Hely, MA, Morris, JGL, Traficante, R, Reid, WGJ, O'Sullivan, DJ, Williamson, PM. The Sydney multicentre study of Parkinson's disease: progression and mortality at 10 years. J Neurol Neurosurg Psychiatry 1999; 67: 300–7.Google Scholar
11Wade, DT, Gage, H, Owen, C, Trend, P, Grossmith, C, Kaye, J. Multidisciplinary rehabilitation for people with Parkinson's disease: a randomised controlled study. J Neurol Neurosurg Psychiatry 2003; 74: 158–62.CrossRefGoogle ScholarPubMed
12Raggi, A, Leonardi, M, Ajovalasit, Det al.Disability and profiles of functioning of patients with Parkinson's disease described with ICF classification. Int J Rehabil Res 2011; 34: 141–50.Google Scholar
13Faherty, CJ, Raviie Shepherd, K, Herasimtschuk, A, Smeyne, RJ. Environmental enrichment in adulthood eliminates neuronal death in experimental Parkinsonism. Brain Res Mol Brain Res 2005; 134: 170–79.Google Scholar
14Frazzitta, G, Balbi, P, Maestri, R, Bertotti, G, Boveri, N, Pezzoli, G. The beneficial role of intensive exercise on Parkinson disease progression. Am J Phys Med Rehabil 2013; 92: 523–32.CrossRefGoogle ScholarPubMed
15Morris, ME, Martin, CL, Schenkman, ML. Striding out with Parkinson disease: evidence-based physical therapy for gait disorders. Phys Ther 2010; 90: 280–88.Google Scholar
16Keus, SH, Bloem, BR, Hendriks, EJ, Bredero-Cohen, AB, Munneke, M; Practice Recommendations Development Group. Evidence-based analysis of physical therapy in Parkinson's disease with recommendations for practice and research. Mov Disord 2007; 22: 451–60.Google Scholar
17Dibble, LE, Cavanaugh, JT, Earhart, GM, Ellis, TD, Ford, MP, Foreman, KB. Charting the progression of disability in parkinson disease: Study protocol for a prospective longitudinal cohort study. BMC Neurol 2010; 10: 110.Google Scholar
18Klein, C, Prokhorov, T, Miniovitz, A, Dobronevsky, E, Rabey, JM. Admission of Parkinsonian patients to a neurological ward in a community hospital. J Neural Transm 2009; 116: 1509–12.Google Scholar
19Jankovic, J. Parkinson's disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry 2008; 79: 368–76.CrossRefGoogle ScholarPubMed
20Boonstra, TA, van der Kooij, H, Munneke, M, Bloem, BR. Gait disorders and balance disturbances in Parkinson's disease: clinical update and pathophysiology. Curr Opin Neurol 2008; 21: 461–71.Google Scholar
21Kim, SD, Allen, NE, Canning, CG, Fung, VS. Postural instability in patients with Parkinson's disease. Epidemiology, pathophysiology and management. CNS Drugs 2013; 27: 97–112.Google Scholar
22Franchignoni, F, Martignoni, E, Ferriero, G, Pasetti, C. Balance and fear of falling in Parkinson's disease. Parkinsonism Relat Disord 2005; 11: 427–33.Google Scholar
23Hely, MA, Reid, WG, Adena, MA, Halliday, GM, Morris, JG. The Sydney multicenter study of Parkinson's disease: the inevitability of dementia at 20 years. Mov Disord 2008; 23: 837–44.CrossRefGoogle Scholar
24Balash, Y, Peretz, C, Leibovich, G, Herman, T, Hausdorff, JM, Giladi, N. Falls in outpatients with Parkinson's disease: frequency, impact and identifying factors. J Neurol 2005; 252: 1310–15.Google Scholar
25Latt, MD, Lord, SR, Morris, JG, Fung, VS. Clinical and physiological assessments for elucidating falls risk in Parkinson's disease. Mov Disord 2009; 24: 1280–89.Google Scholar
26Kamata, N, Matsuo, Y, Yoneda, T, Shinohara, H, Inoue, S, Abe, K. Overestimation of stability limits leads to a high frequency of falls in patients with Parkinson's disease. Clin Rehabil 2007; 21: 357–61.Google Scholar
27Mak, MK, Pang, MY. Fear of falling is independently associated with recurrent falls in patients with Parkinson's disease: a 1-year prospective study. J Neurol 2009; 256: 1689–95.CrossRefGoogle ScholarPubMed
28Royal Dutch Society for Physical Therapy(KNGF). KNGF guidelines for physical therapy in patients with Parkinson's disease 2006. Available at: http://www.appde.eu/pdfs/Dutch%20Parkinson's%20Physiotherapy%20Guidelines.pdf (accessed 3 October 2013).Google Scholar
29Deane, KH, Jones, D, Playford, ED, Ben-Shlomo, Y, Clarke, CE. Physiotherapy for patients with Parkinson's disease: a comparison of techniques. Cochrane Database Syst Rev 2001. Available at: http://www.ncbi.nlm.nih.gov/pubmed/11687029 (accessed 10 August 2013).Google Scholar
30Tomlinson, CL, Patel, S, Meek, Cet al. Physiotherapy versus placebo or no intervention in Parkinson's disease. Cochrane Database Syst Rev 2013. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24018704 (accessed 3 October 2013).Google Scholar
31Deane, KH, Jones, D, Playford, ED, Ben-Shlomo, Y, Clarke, CE. Physiotherapy versus placebo or no intervention in Parkinson's disease. Cochrane Database Syst Rev 2001. Available at: http://www.ncbi.nlm.nih.gov/pubmed/11687029 (accessed 10 August 2013).Google Scholar
32Goodwin, VA, Richards, SH, Taylor, RS, Taylor, AH, Campbell, JL. The effectiveness of exercise interventions for people with Parkinson's disease: a systematic review and meta-analysis. Mov Disord 2008; 23: 631–40.Google Scholar
33Allen, NE, Sherrington, C, Paul, SS, Canning, CG. Balance and falls in Parkinson's disease: a meta-analysis of the effect of exercise and motor training. Mov Disord 2011; 26: 1605–15.Google Scholar
34Dibble, LE, Addison, O, Papa, E. The effects of exercise on balance in persons with Parkinson's disease: a systematic review across the disability spectrum. J Neurol Phys Ther 2009; 33: 14–26.Google Scholar
35National Health and Medical ResearchCouncil. NHMRC levels of evidence and grades for recommendations for developers of guidelines. Australian Government 2009. Available at: www.nhmrc.gov.au/_files_nhmrc/file/guidelines/developers/nhmrc_levels_grades_evidence_120423.pdf (accessed 22 November 2013).Google Scholar
36Li, F, Harmer, P, Fitzgerald, Ket al.Tai chi and postural stability in patients with Parkinson's disease. N Engl J Med 2012; 366: 511–19.Google Scholar
37Smania, N, Corato, E, Tinazzi, Met al.Effect of balance training on postural instability in patients with idiopathic Parkinson's disease. Neurorehabil Neural Repair 2010; 24: 826–34.CrossRefGoogle ScholarPubMed
38Rubenis, J. A rehabilitational approach to the management of Parkinson's disease. Parkinsonism Relat Disord 2007; 13 suppl 3: 495–97.Google Scholar
39Johnston, M, Chu, E. Does attendance at a multidisciplinary outpatient rehabilitation program for people with Parkinson's disease produce quantitative short term or long term improvements? A systematic review. NeuroRehabilitation 2010; 26: 375–83.Google Scholar
40Morris, ME, Iansek, R, Kirkwood, B. A randomized controlled trial of movement strategies compared with exercise for people with Parkinson's disease. Mov Disord 2009; 24: 64–71.Google Scholar
41Frazzitta, G, Bertotti, G, Riboldazzi, Get al.Effectiveness of intensive inpatient rehabilitation treatment on disease progression in parkinsonian patients: a randomized controlled trial with 1-year follow-up. Neurorehabil Neural Repair 2012; 26: 144–50.Google Scholar
42Ward, D, Drahota, A, Gal, D, Severs, M, Dean Taraneh, P. Care home versus hospital and own home environments for rehabilitation of older people. Cochrane Database Syst Rev 2008. Available at: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003164.pub2/abstract (accessed 1 November 2013).Google Scholar
43Barnes, MP, Radermacher, H. Neurological rehabilitation in the community. J Rehabil Med 2001; 33: 244–48.Google Scholar
44van der Eijk, M, Faber, MJ, Al Shamma, S, Munneke, M, Bloem, BR. Moving towards patient-centered healthcare for patients with Parkinson's disease. Parkinsonism Relat Disord 2011; 17: 360–64.Google Scholar
45Forster, A, Young, J, Lambley, R, Langhorne, P. Medical day hospital care for the elderly versus alternative forms of care. Cochrane Database Syst Rev 2008. Available at: http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001730/pdf_fs.html (accessed 1 November 2013).Google Scholar
46McGinley, JL, Martin, C, Huxham, FEet al.Feasibility, safety, and compliance in a randomized controlled trial of physical therapy for Parkinson's disease. Parkinsons Dis 2012; doi:10.1155/2012/795294.CrossRefGoogle Scholar
47Steffen, T, Petersen, C, Dvorak, L. Community-based exercise and wellness program for people diagnosed with Parkinson disease: experiences from a 10-month trial. J Geriatr Phys Ther 2012; 35: 173–80.Google Scholar
48Trend, P, Kaye, J, Gage, H, Owen, C, Wade, D. Short-term effectiveness of intensive multidisciplinary rehabilitation for people with Parkinson's disease and their carers. Clin Rehabil 2002; 16: 717–25.Google Scholar
49Ashworth, NL, Chad, KE, Harrison, EL, Reeder, BA, Marshall, SC. Home versus center based physical activity programs in older adults. Cochrane Database Syst Rev 2005. Available at: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004017.pub2/abstract (accessed 1 November 2013).Google Scholar
50Dereli, EE, Yaliman, A. Comparison of the effects of a physiotherapist-supervised exercise programme and a self-supervised exercise programme on quality of life in patients with Parkinson's disease. Clin Rehabil 2010; 24: 352–62.Google Scholar
51Parker, SG, Oliver, P, Pennington, Met al.Rehabilitation of older patients: day hospital compared with rehabilitation at home. Clinical outcomes. Age Ageing 2011; 40: 557–62.CrossRefGoogle ScholarPubMed
52Reis, T. Impact of forced exercise on patients with Parkinson's disease [abstract]. PM and R 2012; 4 suppl 2: 291.Google Scholar
53Lun, V, Pullan, N, Labelle, N, Adams, C, Suchowersky, O. Comparison of the effects of a self-supervised home exercise program with a physiotherapist-supervised exercise program on the motor symptoms of Parkinson's disease. Mov Disord 2005; 20: 971–75.Google Scholar
54Barker, LN, Ziino, C. Community rehabilitation: ‘home versus centre’ guidelines for choosing the optimal treatment location. Int J Rehabil Res 2010; 33: 115–23.Google Scholar
55Hackney, ME, Earhart, GM. Health-related quality of life and alternative forms of exercise in Parkinson disease. Parkinsonism Relat Disord 2009; 15: 644–48.Google Scholar
56Goodwin, VA, Richards, SH, Henley, W, Ewings, P, Taylor, AH, Campbell, JL. An exercise intervention to prevent falls in people with Parkinson's disease: a pragmatic randomised controlled trial. J Neurol Neurosurg Psychiatry 2011; 82: 1232–38.Google Scholar
57Tickle-Degnen, L, Ellis, T, Saint-Hilaire, MH, Thomas, CA, Wagenaar, RC. Self-management rehabilitation and health-related quality of life in Parkinson's disease: a randomized controlled trial. Mov Disord 2010; 25: 194–204.Google Scholar
58English, C, Hillier, SL. Circuit class therapy for improving mobility after stroke. Cochrane Database Syst Rev 2010. Available at: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007513.pub2/abstract (accessed 13 September 2013).Google Scholar
59Wevers, L, van de Port, I, Vermue, M, Mead, G, Kwakkel, G. Effects of task-oriented circuit class training on walking competency after stroke: a systematic review. Stroke 2009; 40: 2450–59.Google Scholar
60Allen, NE, Canning, CG, Sherrington, Cet al.The effects of an exercise program on fall risk factors in people with Parkinson's disease: a randomized controlled trial. Mov Disord 2010; 25: 1217–25.Google Scholar
61van de Port, IG, Wevers, L, Roelse, H, van Kats, L, Lindeman, E, Kwakkel, G. Cost-effectiveness of a structured progressive task-oriented circuit class training programme to enhance walking competency after stroke: the protocol of the FIT-Stroke trial. BMC Neurol 2009; 9: 43.CrossRefGoogle ScholarPubMed
62Shulman, LM, Katzel, LI, Ivey, FMet al.Randomized clinical trial of 3 types of physical exercise for patients with Parkinson disease. JAMA Neurol 2013; 70: 183–90.Google Scholar
63Gobbi, LT, Oliveira-Ferreira, MD, Caetano, MJet al.Exercise programs improve mobility and balance in people with Parkinson's disease. Parkinsonism Relat Disord 2009; 15 suppl 3: 49–52.Google Scholar
64Schenkman, M, Hall, DA, Baron, AE, Schwartz, RS, Mettler, P, Kohrt, WM. Exercise for people in early- or mid-stage Parkinson disease: a 16-month randomized controlled trial. Phys Ther 2012; 92: 1395–410.Google Scholar
65Ayan, C, Cancela, J. Feasibility of 2 different water-based exercise training programs in patients with Parkinson's disease: a pilot study. Arch Phys Med Rehabil 2012; 93: 1709–14.Google Scholar
66Dibble, LE, Hale, TF, Marcus, RL, Gerber, JP, LaStayo, PC. High intensity eccentric resistance training decreases bradykinesia and improves quality of life in persons with Parkinson's disease: a preliminary study. Parkinsonism Relat Disord 2009; 15: 752–57.Google Scholar
67Ganesan, M, Sathyaprabha, TN, Gupta, A, Pal, PK. Effect of partial weight-supported treadmill gait training on balance in patients with Parkinson disease. PM and R 2013. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24021298 (accessed 14 November 2013).Google Scholar
68de Dreu, MJ, van der Wilk, AS, Poppe, E, Kwakkel, G, van Wegen, EE. Rehabilitation, exercise therapy and music in patients with Parkinson's disease: a meta-analysis of the effects of music-based movement therapy on walking ability, balance and quality of life. Parkinsonism Relat Disord 2012; 18 suppl 1: 114–19.Google Scholar
69King, LA, Horak, FB. Delaying mobility disability in people with Parkinson disease using a sensorimotor agility exercise program. Phys Ther 2009; 89: 384–93.Google Scholar
70Sherrington, C, Whitney, JC, Lord, SR, Herbert, RD, Cumming, RG, Close, JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc 2008; 56: 2234–43.Google Scholar
71Fritz, S, Merlo-Rains, A, Rivers, Eet al.Feasibility of intensive mobility training to improve gait, balance, and mobility in persons with chronic neurological conditions: a case series. J Neurol Phys Ther 2011; 35: 141–47.Google Scholar
72White, DK, Wagenaar, RC, Ellis, TD, Tickle-Degnen, L. Changes in walking activity and endurance following rehabilitation for people with Parkinson disease. Arch Phys Med Rehabil 2009; 90: 43–50.Google Scholar
73Warburton, DE, Nicol, CW, Bredin, SS. Prescribing exercise as preventive therapy. CMAJ 2006; 174: 961–74.Google Scholar
74Fisher, BE, Wu, AD, Salem, GJet al.The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson's disease. Arch Phys Med Rehabil 2008; 89: 1221–29.Google Scholar
75Hoehn, MM, Yahr, MD. Parkinsonism: onset, progression and mortality. Neurology 1967; 17: 427–42.Google Scholar
76Canning, CG, Sherrington, C, Lord, SR, Close, JCT, Heller, G, Heritier, S. Exercise for falls prevention in Parkinson's disease: a randomised controlled trial [abstract]. Mov Disord 2013; 28 suppl 1: 442.Google Scholar
77Hely, MA, Morris, JG, Reid, WG, Trafficante, R. Sydney Multicenter Study of Parkinson's disease: non-L-dopa-responsive problems dominate at 15 years. Mov Disord 2005; 20: 190–99.Google Scholar
78Zieschang, T, Schwenk, M, Oster, P, Hauer, K. Sustainability of motor training effects in older people with dementia. J Alzheimers Dis 2013; 34: 191–202.Google Scholar
79Skidmore, FM, Patterson, SL, Shulman, LM, Sorkin, JD, Macko, RF. Pilot safety and feasibility study of treadmill aerobic exercise in Parkinson disease with gait impairment. J Rehabil Res Dev 2008; 45: 117–24.Google Scholar
80Fahn, S, Elton, RL. Unified Parkinson's Disease Rating Scale. In Fahn, S, Marsden, CD, Calne, DB, Goldestein, M (eds), Recent Developments in Parkinson's Disease. Florham Park, NJ: Macmillan Health Care Information, 1987; pp. 153–63.Google Scholar
81Rossier, P, Wade, DT. Validity and reliability comparison of 4 mobility measures in patients presenting with neurologic impairment. Arch Phys Med Rehabil 2001; 82: 9–13.Google Scholar
82Butland, RJ, Pang, J, Gross, ER, Woodcock, AA, Geddes, DM. Two-, six- and 12-minute walking tests in respiratory disease. Br Med J (Clin Res Ed) 1982; 284: 1607–8.Google Scholar
83Berg, KO, Wood-Dauphinee, SL, Williams, JI, Maki, B. Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992; 83 suppl 2: 7–11.Google Scholar
84Podsiadlo, D, Richardson, S. The timed ‘Up & Go’: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39: 142–48.Google Scholar
85Hill, KD, Bernhardt, J, McGann, AM, Maltese, D, Bercovits, D. A new test of dynamic standing balance for stroke patients: reliability, validity and comparison with healthy elderly. Physiother Can 1996; 48: 257–62.Google Scholar
86Duncan, PW, Weiner, DK, Chandler, J, Studenski, S. Functional reach: a new clinical measure of balance. J Gerontol 1990; 45: M192–97.Google Scholar
87Tinetti, ME, Richman, D, Powell, L. Falls efficacy as a measure of fear of falling. J Gerontol 1990; 45: P239–43.Google Scholar
88Giladi, N, Shabtai, H, Simon, ES, Biran, S, Tal, J, Korczyn, AD. Construction of freezing of gait questionnaire for patients with Parkinsonism. Parkinsonism Relat Disord 2000; 6: 165–70.Google Scholar
89Ware, JE Jr, Sherbourne, CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 473–83.Google Scholar
90Jenkinson, C, Fitzpatrick, R, Peto, V, Greenhall, R, Hyman, N. The Parkinson's Disease Questionnaire (PDQ-39): development and validation of a Parkinson's disease summary index score. Age Ageing 1997; 26: 353–57.Google Scholar
91Storey, JE, Rowland, JT, Basic, D, Conforti, DA, Dickson, HG. The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale. Int Psychogeriatr 2004; 16: 13–31.Google Scholar
92Yesavage, JA, Brink, TL, Rose, TLet al.Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982; 17: 37–49.Google Scholar
93Folstein, MF, Folstein, SE, McHugh, PR. ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.CrossRefGoogle Scholar
94Steffen, T, Seney, M. Test–retest reliability and minimal detectable change on balance and ambulation tests, the 36-item Short-Form Health Survey, and the Unified Parkinson Disease Rating Scale in people with parkinsonism. Phys Ther 2008; 88: 733–46.Google Scholar
95Qutubuddin, AA, Pegg, PO, Cifu, DX, Brown, R, McNamee, S, Carne, W. Validating the Berg Balance Scale for patients with Parkinson's disease: a key to rehabilitation evaluation. Arch Phys Med Rehabil 2005; 86: 789–92.Google Scholar
96Giladi, N, Tal, J, Azulay, Tet al.Validation of the freezing of gait questionnaire in patients with Parkinson's disease. Mov Disord 2009; 24: 655–61.Google Scholar
97Ertan, FS, Ertan, T, Kiziltan, G, Uygucgil, H. Reliability and validity of the Geriatric Depression Scale in depression in Parkinson's disease. J Neurol Neurosurg Psychiatry 2005; 76: 1445–47.Google Scholar
98Fitzpatrick, R, Norquist, JM, Jenkinson, C. Distribution-based criteria for change in health-related quality of life in Parkinson's disease. J Clin Epidemiol 2004; 57: 40–44.Google Scholar
99Gage, H, Kaye, J, Owen, C, Trend, P, Wade, D. Evaluating rehabilitation using cost-consequences analysis: an example in Parkinson's disease. Clin Rehabil 2006; 20: 232–38.Google Scholar
100Li, F, Harmer, P. Tai Chi training to reduce falls in patients with Parkinson's disease – a cost-effectiveness analysis [abstract]. Mov Disord 2013; 28 suppl 1: 104.Google Scholar
101Munneke, M, Nijkrake, MJ, Keus, SHet al.Efficacy of community-based physiotherapy networks for patients with Parkinson's disease: a cluster-randomised trial. Lancet Neurol 2010; 9: 46–54.Google Scholar
102Fletcher, E, Goodwin, VA, Richards, SH, Campbell, JL, Taylor, RS. An exercise intervention to prevent falls in Parkinson's disease: an economic evaluation [abstract]. Mov Disord 2013; 28 suppl 1: 139.Google Scholar
103Canning, CG, Sherrington, C, Lord, SRet al.Exercise therapy for prevention of falls in people with Parkinson's disease: a protocol for a randomised controlled trial and economic evaluation. BMC Neurol 2009; 9: 4.Google Scholar
104Watts, JJ, McGinley, JL, Huxham, Fet al.Cost effectiveness of preventing falls and improving mobility in people with Parkinson disease: protocol for an economic evaluation alongside a clinical trial. BMC Geriatr 2008; 8: 23.Google Scholar
105Abrantes, AM, Friedman, JH, Brown, RAet al.Physical activity and neuropsychiatric symptoms of Parkinson disease. J Geriatr Psychiatry Neurol 2012; 25: 138–45.Google Scholar
106Murtaugh, B, Albert, MV, Karvelas, K, Marciniak, CM, Toledo, SD. Does a supervised program in physical therapy and/or occupational therapy improve pain scores in patients with Parkinson disease? PM and R 2012; 4 suppl 2: 314–15.Google Scholar
107Rodrigues de Paula, F, Teixeira-Salmela, LF, Coelho de Morais Faria, CD, Rocha de Brito, P, Cardoso, F. Impact of an exercise program on physical, emotional, and social aspects of quality of life of individuals with Parkinson's disease. Mov Disord 2006; 21: 1073–77.Google Scholar