2023-10-25 23:00:00
The physiotherapist is one of the “ professionals involved on a systematic basis “. His place throughout this journey is specified: particularly at the start of the illness, he accompanies the patient following the diagnosis, has an ETP mission to convey to the patient the need to practice regular physical activity, for to educate them on how to do the right exercises and to advise them on sports practice.
In fact, the diagnostic announcement is very rarely followed by support and is very frequently experienced in a brutal way by the patient.
« The announcement of Parkinson’s disease constitutes, in most cases, a traumatic event (…). It is often carried out brutally, without explanations, without support or psychological support. » explains Dr. Brefel Courbon, Neurologist, Parkinson Expert Center Toulouse.
Post-diagnosis support consultations are offered mainly in regional expert hospital centers (26 in France to date); the vast majority of patients, diagnosed and followed by a private neurologist in town, therefore do not benefit from it.
Access to ETP, mainly offered by multidisciplinary teams within specific programs, is therefore extremely limited. Patients also report coordination issues between their healthcare professionals.
Access to physiotherapy treatment is particularly too late, which has an influence on the patient’s degree of autonomy (we can talk about a loss of luck; but also an accelerated physical deterioration and more human help requested) : 61% of physiotherapists consider that patients are not taken care of at the right time.
Research has also shown the importance of practicing physical activity in the management and secondary and tertiary prevention of Parkinson’s disease.
Physiotherapy treatment is today recognized as being as important as drug treatments: it is in fact the only treatment that exists for certain symptoms such as posture, balance or even walking disorders.
Living with a chronic illness requires developing psychosocial skills to use good practices and be able to act to live better with the illness. However, in the current societal context, we see that access to information is insufficient: in France, the level of health literacy is low.
In addition, statistics show that Parkinson’s disease affects more socio-economic categories
low professional standards, having less access to this information.
Sick people are also faced with problems linked to medical and paramedical deserts and inequalities in access to care depending on the place where they live.
In certain regions, there are only 2.2 to 2.8 neurologists per 100,000 inhabitants (in 6 regions for an average of 4.4 per 100,000 inhabitants) and only 87 to 90 physiotherapists per 100,000 inhabitants (notably in the Center -Val de Loire and Normandy – on average 135 physiotherapists per 100,000 inhabitants).
Current physiotherapy treatment for Parkinson’s disease is also far removed from the HAS recommendations in terms of starting (late and not from diagnosis), the nature of the care offered and the number and frequency of sessions.
Sick people indeed encounter difficulties in accessing this care due to the lack of available slots for physiotherapists but also to a lack of interest on their part for this care which is often frightening due to its lack of knowledge by these professionals.
In fact, 75% of physiotherapists have less than 10% of Parkinson’s patients among their patients, 32% of them have a negative image of the disease and 80% consider themselves moderately or insufficiently trained.
This is confirmed when we question sick people who, according to our survey carried out in 2022, are more than a quarter (28%) not to benefit from any physiotherapy follow-up and 22% not to be followed by a physiotherapist after 10 years of illness. And for people who benefit from physiotherapy, 41% consider that they could be better trained in the disease.
The amounts of expenditure per patient represented by this care have notably decreased in less
of 10 years: from €578/patient in 2012 to €487/patient in 2020, a drop of 15%.
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