What non-pharmacological interventions are recommended for patients with Parkinson's Disease to improve their quality of life?

Non-pharmacological interventions recommended for patients with Parkinson's disease to improve their quality of life include:

• Access to Parkinson's disease nurse specialists for clinical monitoring, medication adjustment, ongoing support, and reliable information for patients and carers.
• Physiotherapy and physical activity: Referral to physiotherapists experienced in Parkinson's disease for assessment, education, and advice, especially in early stages. Parkinson's disease-specific physiotherapy is recommended for balance or motor function problems. Exercise interventions, including treadmill training and cueing strategies, have been shown to improve motor symptoms, gait parameters, and reduce fall risk.
• Occupational therapy: Referral to occupational therapists experienced in Parkinson's disease for assessment, education, and advice on motor and non-motor symptoms, particularly for difficulties with activities of daily living.
• Speech and language therapy: Referral for assessment and therapy to address communication, swallowing, and saliva management problems. Techniques include expiratory muscle strength training and attention to effort therapies. Alternative communication aids may be considered as the disease progresses.
• Nutrition advice: Referral to dietitians for specialist advice, including discussion of a protein redistribution diet for those on levodopa experiencing motor fluctuations, and advice to maintain adequate protein intake and take vitamin D supplements.
• Alexander Technique: Considered for people experiencing balance or motor function problems, with evidence of improvement in self-assessed disability.
• Multidisciplinary team management: Involving specialists in movement disorders, Parkinson's disease nurse specialists, physiotherapists, occupational therapists, and speech and language therapists to address motor and non-motor symptoms comprehensively.

These interventions aim to maintain and improve motor function, manage non-motor symptoms, reduce falls, and support communication and daily living activities, thereby enhancing quality of life for people with Parkinson's disease.

References: NICE NG71,NICE CKS