Perhaps it is because one is in rehabilitation, that one’s interest turns towards rehabilitation and Parkinson’s Disease. Sounds like a reasonable explanation.
This article from 2017 looked at rates of utilization of rehabilitative services, looking at several demographics: Utilization of rehabilitation therapy services in Parkinson disease in the United States (This article is on PubMed and is open access).
The authors. …”found that 75% of Medicare beneficiaries diagnosed with PD did not receive rehabilitative therapies over a 36-month period. While it is not clear what the appropriate utilization rate should be, utilization among patients with PD in the Netherlands and the United Kingdom greatly exceeds what we found in the United States: at least 57% and 54%, respectively.16,17 In this study, predictors of higher (but still low) rates of therapy utilization included PD care by a neurologist, Asian or Caucasian race, and geographic location.
The NICE folks in the UK have a link where one may download their entire set of guidelines for treatment of people with Parkinson’s:
After looking at their recommendations on DBS, I’m not sure I am in total agreement with them there. But other that, they seem to be solid, aimed at the general practitioner, though, not to the Movement Disorders Specialist (my impression).
This article is not available for open access, but here’s the citation:
Rafferty, M.R., Nettnin, E., Goldman, J.G. et al. Frameworks for Parkinson’s Disease Rehabilitation Addressing When, What, and How. Curr Neurol Neurosci Rep 21, 12 (2021). https://doi.org/10.1007/s11910-021-01096-0
There is moderate to strong evidence supporting physical therapy, occupational therapy, and speech-language pathology soon after diagnosis and in response to functional deficits.
We propose a framework of three pathways for rehabilitation care:
(1) consultative proactive rehabilitation soon after diagnosis for assessment, treatment of early deficits, and promotion meaningful activities;
(2) restorative rehabilitation to promote functional improvements; and
(3) skilled maintenance rehabilitation for long-term monitoring of exercise, meaningful activities, safety, contractures, skin integrity, positioning, swallowing, and communication. (emphasis added).
I would agree with the overall framework – I have had some postural issues since the beginning (pre-PD), and assessment and promotion of meaningful activities would have been helpful. I did receive some physical. therapy to correct posture, which did so, only to reveal spinal stenosis. Later on, I had bunionectomies which kept me wheelchair bound or with limited mobility for a year, and restorative rehabilitation was provided and needed. Finally, my own hubris regarding my mobility led to several falls in 2019 and 2020, and are now being addressed with both restorative rehabilitation and skilled maintenance rehabilitation which will hopefully correct the problems and provide the the tools to maintain posture, etc. over the (hopefully) years to come.