A physical therapy decision-making tool for stratifying persons with Parkinson's disease into community exercise classes

Neurodegener Dis Manag. 2019 Dec;9(6):331-346. doi: 10.2217/nmt-2019-0019. Epub 2019 Nov 5.


Aim: Physical therapy and exercise are considered essential components in the management of Parkinson's disease (PD). Using our retrospective data and years of experience in assigning persons with PD to multilevel group classes we propose a two-part physical therapy decision-making tool consisting of participant and exercise program considerations. Methods: Retrospective medical record review and therapist consensus identified evaluation considerations determined to aide clinical decision making. The ability of these variables (i.e., demographics, clinical characteristics, clinical measures cut-offs) to predict the class assignment decision of PD-specialized physical therapists was evaluated using discriminant function analysis. Results: Therapist-assigned groups differed significantly on all clinical measures (p < 0.001) which provided the categorical data required for discriminant analysis. Using all variables, the discriminant function analysis predicted class assignment of the therapists with 79% agreement. Conclusion: This proposed tool provides a framework that may guide the process for increasing access to multilevel group classes.

Keywords: cognitive–motor challenge; community; exercise prescription; functional mobility; group exercise; motor learning; physical therapy; rehabilitation paradigms; sustained practice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Clinical Decision-Making / methods*
  • Cohort Studies
  • Exercise Therapy / methods*
  • Exercise Therapy / trends
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / physiopathology
  • Parkinson Disease / therapy*
  • Physical Therapists* / trends
  • Physical Therapy Modalities* / trends
  • Residence Characteristics*
  • Retrospective Studies