Shirley Ryan AbilityLab, Chicago, IL, USA.
Departments of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Curr Neurol Neurosci Rep. 2021 Feb 22;21(3):12. doi: 10.1007/s11910-021-01096-0.
This review summarizes the evidence on rehabilitation for people with Parkinson's disease, including when to refer, what rehabilitation professionals should address, and how to deliver rehabilitation care.
Clinical practice guidelines support physical therapy, occupational therapy, and speech-language pathology for Parkinson's disease. However, integrating guidelines into practice may be difficult. Implementation studies take into account patient and clinician perspectives. Synthesizing guidelines with implementation research can improve local delivery. There is moderate to strong evidence supporting physical therapy, occupational therapy, and speech-language pathology soon after diagnosis and in response to functional deficits. We propose a framework of three pathways for rehabilitation care: (1) consultative proactive rehabilitation soon after diagnosis for assessment, treatment of early deficits, and promotion meaningful activities; (2) restorative rehabilitation to promote functional improvements; and (3) skilled maintenance rehabilitation for long-term monitoring of exercise, meaningful activities, safety, contractures, skin integrity, positioning, swallowing, and communication.
本文总结了帕金森病患者康复治疗的证据，包括何时转介、康复专业人员应解决哪些问题，以及如何提供康复护理。
临床实践指南支持为帕金森病患者提供物理治疗、作业治疗和言语治疗。然而，将指南纳入实践可能具有挑战性。实施研究考虑了患者和临床医生的观点。将指南与实施研究相结合可以改善当地的服务提供。有中等至高强度的证据支持在诊断后不久以及针对功能缺陷时进行物理治疗、作业治疗和言语治疗。我们提出了康复护理的三个途径框架：（1）诊断后尽早进行咨询性主动康复，以进行评估、治疗早期缺陷和促进有意义的活动；（2）恢复性康复以促进功能改善；（3）熟练的维持性康复，以长期监测运动、有意义的活动、安全、挛缩、皮肤完整性、定位、吞咽和沟通。
