Chandler 1999.
Methods | Parallel group design. Randomisation method was not stated. Method of analysis not described. Treated at home, where they were assessed by a physiotherapist 5 times over a 12‐month period. The amount of physiotherapy was variable and depended on the participant's needs. Assessed at baseline and during the duration of the trial (at 3, 6, 9, and 12 months) (see Outcomes). Assessors were not blinded. |
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Participants | 32 participants in the physiotherapy group and 35 in the control group. Dropouts 6 (physiotherapy), 9 (control). Participants' mean age 65 years (physiotherapy), 66 years (control). 31 males and 21 females completed the study; Hoehn and Yahr for 47 of the participants, 2.6. Inclusion criteria: Idiopathic Parkinson's disease, not receiving physiotherapy, no access (including self‐referral) to a physiotherapy review system. No exclusion criteria stated. |
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Interventions | Physiotherapy: individualised, based on holistic approach in which empowerment of participants and caregivers was a strong element. Aimed to enhance the performance of activities. Gait and balance exercises using verbal, auditory, and visual cues. Exercises to reduce stiffness, improve muscle tone, and increase trunk rotation. Advice on transfers. Education in use of walking aids, reorganisation of environment to reduce hazards and facilitate movement. Leisure pursuits and social contacts encouraged after strategies were adopted to facilitate these. Relaxation techniques (audio tapes and aromatherapy) to improve sleep patterns. Aimed at reducing pain with education in postural awareness, exercise, TENS, and acupuncture. Referral to other health professionals and social services for aids and appliances.
Control: untreated. Drug therapy could vary. |
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Outcomes | Functional Independence Measure* Nottingham extended Activities Daily Living*. UPDRS - motor subsection*. Timed walk*. 9‐Hole peg test*. SF‐36 +. PDQ‐39 +. *Baseline, 3, 6, 9, 12 months. +Baseline, 6, 12 months. Not stated when during day examinations took place. |
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Notes | Participants referred to other health professionals and social services during trial. Occupational therapy component to the physiotherapy. |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Eligibility Criteria | Low risk | |
Randomisation Method | Unclear risk | Randomisation method was not stated. |
Concealment of Allocation | Unclear risk | Randomisation method was not stated. |
Similarity at Baseline | Unclear risk | Only gave information for age split by treatment group. |
Withdrawals Described | High risk | 22% withdrawals. |
Intention To Treat Analysis | Unclear risk | Method of analysis not described. |
Cointerventions Constant | Unclear risk | Drug therapy could vary. |
Blinded Assessors | High risk | Assessors were not blinded. |