Non-Pharmacological Treatment of Parkinson's Disease

Long-term complications of Parkinson's disease (PD) including impairments of speech, swallowing, posture, gait and balance are associated with significant disability. Even with optimal pharmacological (and surgical) interventions, these deficits cannot be controlled satisfactorily in the majority of patients, resulting in a negative impact on quality of life. Rehabilitative measures including physiotherapy, speech training and occupational therapy are often implemented on an empirical basis to counteract the progressive pharmaco-resistant motor disturbances. Studies meeting high methodological standards have been published on this field in recent years, making rehabilitative therapy more evidence-based. In addition, basic science research in animal models of PD has documented the value of exercise for improving motor performance and potentially slowing progression of motor symptoms and neural degeneration. The present article reviews the role of exercise and rehabilitation in the management of PD.