Rehabilitation Gaps and Unmet Needs Across Disability Stages in Patients With Parkinson’s Disease: A National Survey

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IntroductionRehabilitation is essential for managing activities of daily living (ADL)-related motor symptoms in people with Parkinson’s disease (PwPD), which appear early and worsen over time, highlighting the importance of early, continuous intervention. However, implementation in real-world settings remains limited, and national data on associated factors and alignment with symptom severity are scarce. This study aimed to clarify the current status of rehabilitation implementation by specialized professionals among PwPD in Japan, identify associated factors, and assess whether interventions are provided for relevant problems according to severity.MethodsAn anonymous nationwide online survey was conducted from June to September 2024 among members of the Japan Parkinson’s Disease Association. The survey assessed rehabilitation status, participant characteristics, and ADL-related motor symptoms. Relevant problems were defined based on symptom severity and perceived importance.ResultsAmong 355 responses, data from 300 community-dwelling PwPD were analyzed. Of these, 66.3% received rehabilitation. The rehabilitation cohort had longer disease duration, more severe ADL-related motor symptoms, lower ambulation levels, and more frequent falls, while the non-rehabilitation cohort included more employed individuals. Most participants with mild relevant problems received no intervention. Even for moderate to severe problems, rehabilitation was often limited to mobility-related domains. Interventions for self-care, communication, and swallowing difficulties remained notably underutilized.ConclusionThese findings reveal substantial gaps and unmet needs in rehabilitation implementation, underscoring the global need for proactive, domain-specific, multidisciplinary rehabilitation to reduce long-term disability and to better meet the needs of PwPD across diverse healthcare systems.

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