Effects of specialised physiotherapy on mortality in Parkinson's disease: a prospective observational study.

Previous studies found that specialised allied health interventions in people with Parkinson's disease (PD) are associated with fewer complications and lower costs, as compared to usual care. Here we studied the association between specialised physiotherapy with mortality risk in a real world setting. We performed a retrospective cohort study using a health insurance claims database capturing persons with PD in the Netherlands with a follow-up of ten years. In persons treated for PD-related indications (n = 37,729), specialised physiotherapy was associated with a lower mortality rate ratio (0.89; 95% CI [0.86; 0.92]; P < 0.0001) than usual care physiotherapy. The association was attenuated in persons with PD with worse mental health (1.00), higher healthcare costs (0.91) in the year prior to enrolment and for females (0.91). These findings suggest that specialised physiotherapy for PD-related indications may delay death in persons with PD, although we cannot exclude the possibility of residual confounding.