by Samyra Keus
At the end of this year, the first European Physiotherapy Guideline for Parkinson’s Disease will be published, providing evidence-based recommendations for physiotherapy care in Parkinson’s disease: Why and when should patients be referred? What interventions should be applied when? How can self-management be supported?
Currently, the delivery of allied health care services to people with Parkinson’s disease is inadequate. Initiated by ParkinsonNet (www.ParkinsonNet.nl/welcome) and the Royal Dutch Society for Physical Therapy (KNGF), a guideline to tackle part of this is being developed. This is done in a joint collaboration of 19 European physiotherapy associations (members of the World Confederation for Physical Therapy), the Association of Physiotherapists in Parkinson’s disease Europe (APPDE) and the European Parkinson’s Disease Association (EPDA). A panel of the European Section of the Movement Disorder Society will review the final criteria for referral to a physiotherapist.
The guideline will be an update and optimised version of the 2004 Dutch KNGF guideline. This high quality guideline, initiated by Prof. Dr. Bastiaan Bloem, Dr. Marten Munneke and the Dutch Parkinson Society, still is the only one available in its field worldwide. New to the development of the European guideline is the participation of patients all throughout the development process. Moreover, the development process started off with gaining insight in the needs and barriers of patients and physiotherapists in current Parkinson care. Focus groups and a survey in which over 4,000 physiotherapists throughout Europe participated provided this insight.
The barriers and needs identified are being addressed in the future guideline as well as in its future implementation. For the clinical recommendations, a systematic literature search and evidence appraisal using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system is used, surmounted by expert opinion and patient values. With GRADE, for each key question, the body of evidence across studies is appraised collectively. The system is endorsed by, amongst many others, the WHO, the Cochrane Collaboration, NICE and the BMJ.
The European guideline is being made for and by healthcare professionals and people with Parkinson’s disease. The penultimate concept of the guideline will be available for feedback in, approximately, October. We invite you to deliver feedback! To do so, as well as for more information please visit www.appde.eu/EN/european-guideline.asp. For any questions, please get in contact with the project leader, Dr. Samyra Keus: S.Keus@ParkinsonNet.nl
Dr. Samyra Keus is working at the ParkinsonNet at Radboud University Nijmegen Medical Centre, The Netherlands