The Parkinson’s disease rehabilitation — non-pharmaceutical approaches

The article represents clinical trials and attempts of non-drug treatment in Parkinson’s disease (PD). For the first time in the 60s of the previous century, physical exercises were proposed as a correction of motor symptoms in PD. During this period, rehabilitation was considered as a secondary method to the pharmacological and surgical treatment of PD. An analysis of studies conducted over the past 10 years showed that various rehabilitation techniques cannot be compared with each other and that there is no full proof evidence. Initially, the rehabilitation approach was based on empirical experience, but more and more evidence suggest that neuroplasticity is the main mechanism underlying the effects of rehabilitation. Various data indicate an increase in synaptic transmission, an effect on neurotransmission, and a decrease in chronic oxidative stress during physical exposure, which, in turn, can provide a neural basis for rehabilitation in PD. An important issue is whether patients with PD have the ability to reacquire or master new skills. According to reports, the need for non-drug correction in PD is obvious, however, it is necessary to determine the intensity, frequency, continuity of exposure, progressive nature of PD. These recommendations should have an evidence base, and also should correlate with the stages of the disease. The rehabilitation program for PD should be “goal-oriented” and be adapted to the characteristics of each patient individually.