Parkinson's Disease and Nonpharmacologic Treatment Programs

Although objective studies to confirm the role of physical therapy, occupational therapy, and speech therapy in the patient with Parkinson's disease are scarce, each of these therapy modalities can play a certain role in the management of the appropriate patient. In the mildly affected patient, there is little need for any of these interventions; however, as the disease progresses, pharmacologic treatment is usually not totally effective in controlling the signs and symptoms and all of these nonpharmacologic therapy moalities may eventually be utilized. Physical therapy alone cannot effectively treat Parkinson's disease and its long-term effects on patient performance is limited. However, patients and their families often report subjective improvement when physical therapy is used, and these reports cannot be discounted. Improvement with pharmacologic treatment, while more easily assessed objectively, is also not long-lasting. So long as Parkinson's disease remains a progressive disorder, all treatment modalities must be evaluated in the context of a progressively worsening neurologic picture.