Abstract
ABSTRACT: Background: Specialized versus generic physiotherapy (PT) reduces Parkinson’s disease (PD)–related complications. It is unclear (1) whether other specialized allied heath disciplines, including occupational therapy (OT) and speech and language therapy (S<), also reduce complications; (2) whether there is a synergistic effect among multiple specialized disciplines; and (3) whether each allied health discipline prevents specific complications.
Objectives: To longitudinally assessed whether the level of expertise (specialized vs. generic training) of PT, OT, and S< was associated with the incidence rate of PD‐related complications. Methods: We used claims data of all insured persons
with PD in the Netherlands between January 1, 2010, and December 31, 2018. Parkinson Net-trained therapists were classified as specialized, and other therapists as
generic. We used mixed-effects Poisson regression models to estimate rate ratios adjusting for sociodemographic and clinical characteristics.
Results: The population of 51,464 persons with PD(mean age, 72.4 years; standard deviation 9.8) sustained 10,525 PD-related complications during follow-up
(median 3.3 years). Specialized PT was associated with fewer complications (incidence rate ratio [IRR] of specialized versus generic = 0.79; 95% confidence interval, [0.74–0.83]; P < 0.0001), as was specialized OT (IRR = 0.88 [0.77–0.99]; P = 0.03). We found a trend of an association between specialized S< and a lower
rate of PD-related complications (IRR = 0.88 [0.74–1.04]; P = 0.18). The inverse association of specialized OT persisted in the stratum, which also received specialized PT (IRR = 0.62 [0.42–0.90]; P = 0.001). The strongest inverse association of PT was seen with orthopedic injuries (IRR = 0.78 [0.73–0.82]; P < 0.0001) and of S<
with pneumonia (IRR = 0.70 [0.53–0.93]; P = 0.03).
Conclusions: These findings support a wider introduction of specialized allied health therapy expertise in PD care and conceivably for other medical conditions.
Objectives: To longitudinally assessed whether the level of expertise (specialized vs. generic training) of PT, OT, and S< was associated with the incidence rate of PD‐related complications. Methods: We used claims data of all insured persons
with PD in the Netherlands between January 1, 2010, and December 31, 2018. Parkinson Net-trained therapists were classified as specialized, and other therapists as
generic. We used mixed-effects Poisson regression models to estimate rate ratios adjusting for sociodemographic and clinical characteristics.
Results: The population of 51,464 persons with PD(mean age, 72.4 years; standard deviation 9.8) sustained 10,525 PD-related complications during follow-up
(median 3.3 years). Specialized PT was associated with fewer complications (incidence rate ratio [IRR] of specialized versus generic = 0.79; 95% confidence interval, [0.74–0.83]; P < 0.0001), as was specialized OT (IRR = 0.88 [0.77–0.99]; P = 0.03). We found a trend of an association between specialized S< and a lower
rate of PD-related complications (IRR = 0.88 [0.74–1.04]; P = 0.18). The inverse association of specialized OT persisted in the stratum, which also received specialized PT (IRR = 0.62 [0.42–0.90]; P = 0.001). The strongest inverse association of PT was seen with orthopedic injuries (IRR = 0.78 [0.73–0.82]; P < 0.0001) and of S<
with pneumonia (IRR = 0.70 [0.53–0.93]; P = 0.03).
Conclusions: These findings support a wider introduction of specialized allied health therapy expertise in PD care and conceivably for other medical conditions.
| Original language | English |
|---|---|
| Pages (from-to) | 223-231 |
| Number of pages | 9 |
| Journal | Movement Disorders |
| Volume | 38 |
| Issue number | 2 |
| Early online date | 24 Nov 2022 |
| DOIs | |
| Publication status | Published - 1 Feb 2023 |
Bibliographical note
© 2022 The Authors. Movement Disorders published byWiley Periodicals LLC on behalf of International
Parkinson and Movement Disorder Society.