Physiotherapy in Parkinson's Disease: Utilisation and Patient Satisfaction

To examine the quality and quantity of physiotherapy care in Parkinson's disease (PD) in the Netherlands, postal questionnaires were sent to 300 PD patients. Patients who had received treatment by a physiotherapist at some stage during the previous year were asked to give approval to contact their therapist. Subsequently, postal questionnaires were sent to 129 physiotherapists who had recently treated the patients that were identified in the first stage of the study. Completed questionnaires were returned by 235 patients and 99 therapists. Sixty percent of patients were currently treated by a physiotherapist, most of them for more than six months. Ninety-five patients had serious problems within at least one of the four core areas of physiotherapy practice in PD (posture, balance, gait, transfers) and were therefore regarded as requiring referral to physiotherapy. Yet, 41% of them received no treatment at the time of enquiry. On the other hand, 75 patients had no serious problems within these core areas, yet half of them currently received treatment. The main goals for treatment were improvement of gait, general physical condition, posture or balance. Treatment mainly comprised active exercises. 60% of patients were treated by therapists without specific interest or education in PD. Most patients were presently satisfied with the treatment, but 11% had previously changed to another therapist because of dissatisfaction. In the Netherlands, referral rates of PD patients to physiotherapy are high and treatment duration is lengthy. Referral seems, to some extent, arbitrary. Scientific evidence for the effectiveness of physiotherapy in PD remains limited.