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AUG 08/2014

The growing need for physios with Parkinson's expertise.

At the moment, there is a growing awareness within the UK of the expanded role that NHS physiotherapy staff can play in effective healthcare provision, particularly at a time when the number of patients with chronic long-term conditions is on the rise.

Earlier this month, a new study highlighted one particular area in which the expertise of physiotherapists could be particularly sorely needed - in the provision of care for people affected by Parkinson's disease, a progressive and devastating neurological condition.

The report outlined the growing need for more physios with training in this field, thus highlighting an underserved target for investment within the NHS - as well as an area of opportunity for those members of staff who already possess the knowledge needed to make a difference.

The need for improved Parkinson's care
Parkinson's is a condition that affects around 127,000 people in the UK, equivalent to around one in every 500 people in the country. The disease is caused by a lack of the chemical dopamine in the brain due to nerve cell loss, leading to symptoms such as physical tremors, rigidity and slowness of movement.

There is no cure for the condition, which develops at varying speeds in different patients and requires a combination of drugs, therapies and surgical interventions to treat effectively.

Physiotherapy can be a key part of this programme of treatment, but at the moment physio services are being underutilised in this regard. According to the recent research from charity organisation Parkinson's UK, 51 per cent of new physios have received no training in managing people with this problem, while only 28 per cent receive regular training on the topic.

Moreover, nearly 13 per cent of physiotherapists who treat people with Parkinson's are in junior band 5 posts, while in 15 per cent of cases, staff are not using outcome measures, which would help to provide evidence of which techniques work best..

Although the audit revealed good news in the fact that 98 per cent of patients had physiotherapy notes that identified interventions in their initial assessment, the overall picture was one of that suggested physios need to be handed a large role in caring for patients with the condition.

How can physios help?
According to research from the Chartered Society of Physiotherapy, Parkinson's disease sufferers can benefit from physio treatment in a number of ways. Over the course of a therapy programme, staff can help patients improve their physical capacity and quality of movement in daily life though walking and transfer training, balance and falls education, and the practice of manual activities such as reaching and grasping.

Principles of education and self-management tend to be at the heart of treatment strategies, with patients being encouraged to get involved in leisure activities and charity-backed programmes to improve their general fitness and remain included in the community. Over time, the physical effects of the condition can be offset, minimising deterioration in terms of strength, endurance, flexibility and balance, while mental health can also benefit.

As such, Parkinson's UK recommends that people diagnosed with the condition should be referred for physiotherapy at an early stage, allowing them to get advice on what this treatment approach can do to address their future symptoms.

It was also proposed that specialist physiotherapists should be called upon to assess and manage people with Parkinson's, ensuring that interventions are evidence-based and patients always receive the most appropriate treatment.

Fiona Lindop, the physiotherapy representative on the audit steering group, said: "I would like to see access to training for all physiotherapists.

"Parkinson's needs specific therapy, and physiotherapists must understand the motor fluctuations, the impact of medications and the principles behind interventions - for instance, using cues and strategies."

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