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@ARTICLE{Guidetti:277982,
      author       = {Guidetti, Matteo and Marceglia, Sara and Bocci, Tommaso and
                      Duncan, Ryan and Fasano, Alfonso and Foote, Kelly D and
                      Hamani, Clement and Krauss, Joachim K and Kühn, Andrea A
                      and Lena, Francesco and Limousin, Patricia and Lozano,
                      Andres M and Maiorana, Natale V and Modugno, Nicola and
                      Moro, Elena and Okun, Michael S and Oliveri, Serena and
                      Santilli, Marco and Schnitzler, Alfons and Temel, Yasin and
                      Timmermann, Lars and Visser-Vandewalle, Veerle and Volkmann,
                      Jens and Priori, Alberto},
      title        = {{I}s physical therapy recommended for people with
                      parkinson's disease treated with subthalamic deep brain
                      stimulation? a delphi consensus study.},
      journal      = {Journal of neuroEngineering and rehabilitation},
      volume       = {22},
      number       = {1},
      issn         = {1743-0003},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DZNE-2025-00514},
      pages        = {80},
      year         = {2025},
      abstract     = {Although deep brain stimulation of the subthalamic nucleus
                      (STN-DBS) induces motor benefits in people with Parkinson's
                      disease (PwPD), its effect on motor axial symptoms (e.g.,
                      postural instability, trunk posture alterations) and gait
                      impairments (e.g., freezing of gait) is still ambiguous.
                      Physical therapy (PT) effectively complements
                      pharmacological treatment to improve postural stability,
                      gait performance, and other dopamine-resistant symptoms
                      (e.g. freezing of gait) in the general population with PD.
                      Despite the positive potential of combined PT and STN-DBS
                      surgery, scientific results are still lacking. We therefore
                      involved worldwide leading experts on DBS and motor
                      rehabilitation in PwPD in a consensus Delphi panel to define
                      the current level of PT recommendation following STN-DBS
                      surgery.After summarizing the few available findings through
                      a systematic scoping review, we identified clinically and
                      academically experienced DBS clinicians (n = 21) to discuss
                      the challenges related to PT following STN-DBS. A 5-point
                      Likert scale questionnaire was used and based on the results
                      of the systematic review, thirty-nine questions were
                      designed and submitted to the panel-half related to general
                      considerations on PT following STN-DBS, and half related to
                      PT treatments.Despite the low-to-moderate quality of data,
                      the few available rehabilitation studies suggested that PT
                      could improve dynamic and static balance, gait performance
                      and posture in the population with PD receiving STN-DBS.
                      Similarly, the panellists strongly agreed that PT might help
                      improve motor symptoms and quality of life, and it may be
                      prescribed to maximize the effects of stimulation. The
                      experts agreed that physical therapists could be part of the
                      multidisciplinary team taking care of the patients. Also,
                      they agreed that conventional PT, but not massage or manual
                      therapy, should be prescribed because of the specificity of
                      STN-DBS implantation.Although RCT evidence is lacking, upon
                      Delphi panel, PT for PwPD receiving STN-DBS can be
                      potentially useful to maximize clinical improvement.
                      However, more research is needed, with RCTs and
                      well-designed studies. The rehabilitation and DBS community
                      should expand this area of research to create guidelines for
                      PT following STN-DBS.},
      keywords     = {Humans / Parkinson Disease: rehabilitation / Parkinson
                      Disease: therapy / Deep Brain Stimulation: methods / Delphi
                      Technique / Subthalamic Nucleus / Physical Therapy
                      Modalities / Consensus / DBS (Other) / Deep brain
                      stimulation (Other) / Delphi consensus (Other) / Motor
                      rehabilitation (Other) / Movement disorders (Other) /
                      Neuromodulation (Other) / Parkinson’s disease (Other) /
                      Physical therapy (Other) / Physiotherapy (Other)},
      cin          = {AG Kühn},
      ddc          = {610},
      cid          = {I:(DE-2719)5000008},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40211348},
      doi          = {10.1186/s12984-025-01616-w},
      url          = {https://pub.dzne.de/record/277982},
}