The current significance of physiotherapeutic measures in the treatment of Parkinson's disease.

Physical measures as adjuvant therapy in Parkinson's disease have so far received insufficient investigation from the viewpoint of either their clinical effectiveness or of their theoretical rationale, although they are widely prescribed in practice and contribute a substantial cost factor to the overall treatment. Most attention has been devoted to movement therapy, which may admittedly only achieve minor improvements in motor performance but contributes substantially to subjective improvement of the well-being of the patients and to the maintenance of their physiological functions. Speech therapy seems to be effective only for patients who are highly motivated and have not suffered any psychological deficits and who continue exercising on their own. Massage, ergonomic treatment approaches and the nowadays fashionable area of various relaxation techniques have received very little attention. Our own trials with vibro-massage (swing-exbusar) for the loosening of muscular rigidity have led to no sustained improvement, and our attempts to improve speech defects in Parkinsonian patients by the application of laser acupuncture have likewise not resulted in improvement.