Physiotherapy in Parkinson's disease in the Czech Republic - a demographic study

Aim: The aim of this study was to investigate the quality and availability of physiotherapy for patients with Parkinson's disease. Materials and methods: Questionnaire inspired by previously published studies was sent to 368 Parkinson's disease patients who met the inclusion criteria (at least one visit in the Movement Disorders Center of the General University Hospital in Prague within the last 2 years; Parkinson's disease, Hoehn & Yahr stage < 5; residence in Prague). The questionnaire consisted of items concerning limitations in six core areas for physiotherapy (gait, transfers, manual dexterity, balance/falls, posture, and physical capacity), limitation in daily living activities, utilization of physiotherapy, patients' satisfaction and other characteristics of the therapy. Results: Questionnaires were returned by 248 patients. Prescription rate in patients with a relevant problem (limitation in a core area and motivation to improve in it) in one of the six core areas ranged from 15% (manual dexterity) to 22% (gait). Most patients (79%) were satisfied with physiotherapy and the over all effect lasted > 3 months in 42/64 patients who answered this question. In total, 10% of the patients changed their physiotherapist due to dissatisfaction. Conclusion: Because of the very low physiotherapy prescription rate, reorganization of Parkinson's disease-related health care is needed in the Czech Republic. An efficient model of health care tested abroad could be ParkinsonNet.