{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T05:06:53Z","timestamp":1787375213702,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T00:00:00Z","timestamp":1669248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000324","name":"Gatsby Charitable Foundation","doi-asserted-by":"publisher","award":["GAT3676"],"award-info":[{"award-number":["GAT3676"]}],"id":[{"id":"10.13039\/501100000324","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008444","name":"Parkinsonfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008444","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003195","name":"Ministry of Economic Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003195","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Specialized versus generic physiotherapy (PT) reduces Parkinson's disease (PD)\u2013related complications. It is unclear (1) whether other specialized allied heath disciplines, including occupational therapy (OT) and speech and language therapy (S&amp;LT), also reduce complications; (2) whether there is a synergistic effect among multiple specialized disciplines; and (3) whether each allied health discipline prevents specific complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To longitudinally assessed whether the level of expertise (specialized vs. generic training) of PT, OT, and S&amp;LT was associated with the incidence rate of PD\u2010related complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used claims data of all insured persons with PD in the Netherlands between January 1, 2010, and December 31, 2018. ParkinsonNet\u2010trained therapists were classified as specialized, and other therapists as generic. We used mixed\u2010effects Poisson regression models to estimate rate ratios adjusting for sociodemographic and clinical characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The population of 51,464 persons with PD (mean age, 72.4\u2009years; standard deviation 9.8) sustained 10,525 PD\u2010related complications during follow\u2010up (median 3.3\u2009years). Specialized PT was associated with fewer complications (incidence rate ratio [IRR] of specialized versus generic\u00a0=\u00a00.79; 95% confidence interval, [0.74\u20130.83]; <jats:italic>P<\/jats:italic> &lt;\u20090.0001), as was specialized OT (IRR\u00a0=\u00a00.88 [0.77\u20130.99]; <jats:italic>P<\/jats:italic>\u00a0=\u20090.03). We found a trend of an association between specialized S&amp;LT and a lower rate of PD\u2010related complications (IRR\u00a0=\u00a00.88 [0.74\u20131.04]; <jats:italic>P<\/jats:italic>\u00a0=\u20090.18). The inverse association of specialized OT persisted in the stratum, which also received specialized PT (IRR\u00a0=\u00a00.62 [0.42\u20130.90]; <jats:italic>P<\/jats:italic>\u00a0=\u20090.001). The strongest inverse association of PT was seen with orthopedic injuries (IRR\u00a0=\u00a00.78 [0.73\u20130.82]; <jats:italic>P<\/jats:italic> &lt;\u20090.0001) and of S&amp;LT with pneumonia (IRR\u00a0=\u00a00.70 [0.53\u20130.93]; <jats:italic>P<\/jats:italic>\u00a0=\u20090.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings support a wider introduction of specialized allied health therapy expertise in PD care and conceivably for other medical conditions. \u00a9 2022 The Authors. <jats:italic>Movement Disorders<\/jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.29274","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T01:19:55Z","timestamp":1669339195000},"page":"223-231","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Specialized Versus Generic Allied Health Therapy and the Risk of Parkinson's Disease Complications"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4306-0532","authenticated-orcid":false,"given":"Amir H.","family":"Talebi","sequence":"first","affiliation":[{"name":"Department of Neurology Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan H.L.","family":"Ypinga","sequence":"additional","affiliation":[{"name":"Department of Neurology Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienke M.","family":"De Vries","sequence":"additional","affiliation":[{"name":"Department of Neurology Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorik","family":"Nonnekes","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marten","family":"Munneke","sequence":"additional","affiliation":[{"name":"Department of Neurology Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bas R.","family":"Bloem","sequence":"additional","affiliation":[{"name":"Department of Neurology Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Heskes","sequence":"additional","affiliation":[{"name":"Institute for Computing and Information Sciences Radboud University  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoav","family":"Ben\u2010Shlomo","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Bristol Medical School University of Bristol  Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4361-4593","authenticated-orcid":false,"given":"Sirwan K.L.","family":"Darweesh","sequence":"additional","affiliation":[{"name":"Department of Neurology Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,24]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Principles of Neurology: McGraw\u2010Hill","author":"Ropper A. 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