A Comparative Analysis of Effects of Rehabilitation Services on Symptomatology of Parkinson’s Disease-An Umbrella Review of Systematic Reviews and Meta-Analyses

Background: Parkinson’s disease is a very common neurological disorder worldwide, both in developing and developed countries as well. It is characterized by motor symptoms such as tremors, rigidity, bradykinesia and postural instability. Besides motor symptoms, it also consists of non-motor symptoms such as sleep disturbance, mood disorders, cognitive impairment and autonomic dysfunctions. This review article aims to look into non-pharmacological interventions that improve the symptomatology of the disease.Method: A detailed literature search on databases i.e. PubMed, Google Scholar and Cochrane Library yielded 730 articles. 14 studies were finalized for inclusion in our review. Quality of included studies was assessed using JBI critical appraisal tool and results were reported after detailed data extraction.Results:The studies involved 9755 participants with a mean age of 61.6 years. Various interventions were assessed, including structured physical exercise, technology-based interventions, Tai Chi, cueing techniques, aquatic physiotherapy, and inspiratory and expiratory breathing training. The most studied outcomes were balance, quality of life, gait, depressive symptoms, vocal function, sleep, and respiratory function. Most studies reported significant improvements in balance, quality of life, depressive symptoms, vocal function, sleep, and respiratory function. Gait improvement was significant in 82% of the studies, while vocal improvement was observed in all studies. Sleep quality showed a moderate but significant enhancement, and respiratory function tests demonstrated positive significant effects compared to control groups.Conclusion: This review demonstrates that aerobic exercises enhance gait and offer neuroprotective benefits in Parkinson's disease. Tai Chi and physical activity improve balance, while augmented and virtual reality gait training support motor learning. Non-motor symptoms are effectively treated with cognitive therapies and pharmacological treatments such as SSRIs, benzodiazepines, and antidepressants. Our study suggests to encourage the incorporation of multidisciplinary approaches involving physiotherapists, occupational therapists, speech therapists, and other healthcare professionals to address the diverse symptoms of Parkinson’s disease.