Adding primary-care rehabilitation to device-aided Parkinson's therapy improves motor-skill maintenance, small RCT finds

An open randomised controlled trial tested whether adding three months of tailored primary-care rehabilitation to device-aided therapy for Parkinson’s disease improved outcomes compared with device-aided therapy alone Primary Study. Of 54 patients enrolled, 45 completed the trial. The primary outcome, assessed using a standardised measure of motor and process skills, showed better maintenance of motor skills at both 6 and 12 months in the rehabilitation group.

Among secondary measures, only perceived health improved more in the intervention group; motor fluctuations improved in both groups, and several other disease-specific scales showed non-significant improvements. The rehabilitation group also showed better cognitive performance at 12 months, though the authors describe this cognitive signal as requiring further confirmation rather than an established finding.

This is a genuine randomised controlled trial, which clears a high evidence bar, but it is a small trial (45 completers) testing a resource-intensive three-month rehabilitation bundle delivered in primary care, in a specific population initiating device-aided Parkinson’s therapy; the authors do not report on feasibility of delivering this intensity of rehabilitation at scale.

For neuro-rehabilitation services, this is evidence that a defined, tailored rehabilitation bundle around the point of device-aided therapy initiation can improve motor and perceived-health outcomes — with the practical open question, not addressed by the trial itself, being whether this specific intensity and duration of primary-care allied health professional input is deliverable within current community rehabilitation capacity.