Combined motor and cognitive therapy shows mixed benefits in Parkinson's disease
Photo by Markus Kammermann / Unsplash
Key Takeaway
Consider combined therapy for specific benefits in daily living and quality of life in Parkinson's disease.
This systematic review and meta-analysis evaluated sequential and simultaneous motor and cognitive treatment compared to motor rehabilitation alone in patients with Parkinson's disease. The primary outcome was functional mobility, with secondary outcomes including balance, gait, activities of daily living, and quality of life. The analysis included sixteen studies, with eight eligible for meta-analysis.
The authors observed that sequential combined treatment showed no clear advantage over motor rehabilitation alone for functional mobility. However, sequential treatment demonstrated a significant benefit for activities of daily living. Simultaneous combined treatment led to improvements in quality of life, but no significant differences were found for functional mobility compared to motor rehabilitation alone.
Key limitations noted by the authors include the heterogeneity of included studies and the lack of reported safety data. The certainty of evidence was not formally assessed in the provided data. Clinical relevance is restrained due to the mixed results and variability in study designs.
Clinicians should interpret these findings cautiously, recognizing that combined therapy may offer selective benefits in daily living and quality of life, but not consistently across all functional domains.
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View Original Abstract ↓
OBJECTIVE: To evaluate the effectiveness of sequential and simultaneous motor and cognitive treatment on motor functions, activities of daily living, and quality of life in people with Parkinson's disease.
DESIGN: Systematic review and meta-analysis.
SUBJECTS/PATIENTS: Patients with Parkinson's disease.
METHODS: A search was conducted in PubMed, Embase, Scopus, Web of Science, and Cochrane Library. Functional mobility was assessed as the main outcome, and balance, gait, activities of daily living, and quality of life as secondary outcomes. Meta-analyses were conducted using mean difference or standardized mean difference with 95% confidence intervals and fixed or random effect models. Heterogeneity was explored, setting a cut-off value of I2 = 50%.
RESULTS: Sixteen studies were included, with 8 -eligible for meta-analysis. Results showed that sequential combined treatment offered no clear advantage over motor rehabilitation alone for functional mobility, although a significant benefit was found for activities of daily living. Results on simultaneous combined treatment suggested improvements in quality of life, but no significant differences between treatments for functional mobility.
CONCLUSION: Motor-cognitive approaches may enhance prefrontal cortex efficiency, supporting complex motor tasks and reducing the risk of falls. Future research should elucidate neural mechanisms and compare simultaneous and sequential strategies to develop personalized, multidisciplinary rehabilitation protocols.
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