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To the Editor I read with interest the article by Clarke et al.1 They provide an interesting randomized clinical trial showing physiotherapy (PT) and occupational therapy (OT) are not associated with immediate or medium-term clinically significant improvements in activities of daily living or quality of life in mild to moderate Parkinson disease (PD). Low doses of PT and OT were delivered in the community or outpatient setting by therapists working within the UK National Health Service per local practice. During 8 weeks of treatment, patients received a median of 4 therapy sessions (mean of 58 minutes each); the mean total dose of both therapies was 263 minutes. Considering 8 weeks have 56 days, the mean of delivered therapy was only 4.69 minutes of both therapies per day. It may be classified, optimistically, as a low dose or, realistically, as an impressive PT/OT treatment nonadherence.
Mestriner RG. Physiotherapy and Occupational Therapy and Mild to Moderate Parkinson Disease. JAMA Neurol. 2016;73(7):894. doi:10.1001/jamaneurol.2016.1280