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Physiotherapy consistently improves balance, postural stability, and gait speed after STN deep brain stimulationPhysiotherapy Shows Promise for Parkinson's Patients After Brain Surgery

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Key Takeaway
Consider physiotherapy as a potentially safe and effective addition to manage motor symptoms after DBS-STN.

This systematic review synthesized 10 studies to evaluate the impact of physiotherapy interventions on patients with Parkinson's disease who have undergone bilateral subthalamic nucleus deep brain stimulation (DBS-STN). The review focused on motor outcomes, including balance, postural stability, gait speed, and functional mobility, as well as secondary outcomes like cognitive and neurophysiological effects.

The authors found that balance, postural stability, gait speed, and functional mobility improved consistently following physiotherapy. However, the review noted that motor severity scores, cognitive effects, and neurophysiological effects remain underexplored. The evidence suggests that physiotherapy is a potentially safe addition to the management of motor symptoms following DBS-STN.

Several limitations were identified, including heterogeneous physiotherapy protocols and a lack of standardized protocols and uniform outcome measures. These factors contribute to the limited data regarding specific motor severity scores and neurophysiological impacts. Clinical application is supported for motor symptom management, but the lack of standardized protocols may limit the ability to predict specific outcomes for cognitive or neurophysiological metrics.

How this fits prior evidence

This finding extends the evidence for adjunctive therapies in Parkinson's disease. It complements the finding that robot-assisted gait training improves balance and walking endurance, and the finding that citicoline is a well-tolerated supportive therapy to improve motor scores. While this review confirms the efficacy of physiotherapy for balance and gait post-DBS-STN, it addresses a gap in the specific management of post-surgical motor symptoms.

A review of 10 studies looked at how physiotherapy helps people with Parkinson's disease who have already undergone a specific type of brain surgery called bilateral subthalamic nucleus deep brain stimulation (DBS-STN). The goal was to see if physical therapy could improve motor symptoms after the procedure.

The review found that patients consistently showed improvements in balance, postural stability, walking speed, and functional mobility. While these physical improvements were consistent, other areas like motor severity scores, cognitive effects, and neurophysiological effects were not well studied in the current research.

Physiotherapy is considered a potentially safe addition to managing motor symptoms after this surgery. However, the evidence is limited because the different programs used were not standardized and many measurements were not uniform. Because the research is limited, patients should talk to their doctors to see how these findings apply to their specific care plan.

What this means for you:
Physiotherapy may improve balance and walking speed for Parkinson's patients after deep brain stimulation surgery.

Common questions

Can physiotherapy help after brain surgery for Parkinson's?

Yes, the review of 10 studies suggests that physiotherapy can be a potentially safe and effective way to manage motor symptoms. Patients who underwent bilateral subthalamic nucleus deep brain stimulation showed consistent improvements in balance, postural stability, and walking speed.

What specific movements improve with physiotherapy?

Patients who participated in physiotherapy programs showed consistent improvements in several areas. These include balance, postural stability, gait speed, and functional mobility. These improvements are specifically noted for those who have had DBS-STN surgery.

Are there any risks to using physiotherapy after surgery?

The review indicates that physiotherapy is potentially safe for patients with Parkinson's who have had DBS-STN surgery. No specific adverse events or serious safety concerns were reported in the studies reviewed.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
BackgroundSubthalamic nucleus deep brain stimulation (DBS-STN) is a recognized treatment for advanced Parkinson’s disease. While it improves some clinical symptoms, especially bradykinesia and rigidity, it has limited application for late motor symptoms. Moreover stimulation-related motor adverse effects can increase the motor burden. There is a clear need to develop additional therapies that complement deep brain stimulation in controlling late motor symptoms. Physical activity is a commonly used and recommended form of therapy for patients with Parkinson’s disease, supplementary to pharmacological therapy. However, there are no clear recommendations including patients after implantation of DBS-STN stimulators in the group undergoing physiotherapy.ObjectiveThe objective of this study is to systematically review the literature on physiotherapy interventions for patients who have undergone DBS-STN implantation and their influence on motor outcomes.MethodsThis systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, and a total of 10 studies were included.ResultsDespite heterogeneous physiotherapy protocols, the main outcomes (balance, postural stability, gait speed, functional mobility) improved consistently, while motor severity scores and cognitive or neurophysiological effects remain underexplored.ConclusionCurrent evidence supports the use of physiotheruapy as a potentially effective and safe addition to the management of motor symptoms in patients after DBS-STN. Future trials with standardized physiotherapy protocols and uniform outcome measures are needed to create overall recommendations.
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