Physiotherapy Interventions for Movement Disorders in Parkinson's Disease: A Scoping Review of Targeted Treatment Approaches

Background: Parkinson's disease (PD) presents with heterogeneous movement disorders, including bradykinesia, rigidity, tremor, postural instability, and gait dysfunction. While conventional physiotherapy broadly addresses PD symptoms, movement disorder-specific interventions may optimize therapeutic outcomes through targeted mechanisms.

Objective: To map the current evidence of physiotherapy interventions specifically designed to address individual movement disorders in PD, evaluate effectiveness, and identify knowledge gaps for future research.

Methods: A scoping review following the Arksey and O'Malley framework searched PubMed, CINAHL, Embase, and Web of Science from 2012 to 2025. Fifteen sources were included: eight systematic reviews/meta-analyses, four scoping reviews, and three clinical guidelines. Data were charted according to movement disorder type, intervention characteristics, and evidence quality.

Results: Twelve physiotherapy intervention categories targeting specific motor impairments in patients with PD were identified. Progressive resistance and amplitude-focused training showed evidence of bradykinesia management. Treadmill training has been shown to benefit gait parameters. Cueing strategies were effective for freezing of gait episodes. Balance training improves functional mobility. Dance therapy, martial arts, virtual reality, and aquatic therapy have shown potential benefits for motor symptoms and quality of life. Most studies reported short-term outcomes with limited long-term follow-up.

Conclusions: Movement disorder-specific physiotherapy interventions are promising for targeted symptom management in patients with PD. Evidence supports resistance training for bradykinesia, cueing strategies for freezing of gait, and treadmill training for gait dysfunction; however, effect sizes and long-term benefits require further investigation. Significant knowledge gaps exist in terms of comparative effectiveness, personalized treatment selection, and sustained benefits. Future research should focus on head-to-head comparisons, standardized outcome measures and longer follow-up periods.