Understanding Low Back Pain in Individuals with Parkinson’s Disease: a Scoping Review of Physiotherapy Interventions

Autori

Sara Borghi [Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum – University of Bologna, Bologna, Italy] [Department of Physical Medicine and Rehabilitation, Azienda USL Bologna, Ospedale di Bentivoglio, Bologna, Italy]

Angelo Russo [Physical Therapy and Rehabilitation Unit, Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy]

Mattia Longo [Bachelor in Physiotherapy – Alma Mater Studiorum – University of Bologna, 40138 Bologna (BO)]

Lorenzo D’Orio [Bachelor in Physiotherapy – Alma Mater Studiorum – University of Bologna, 40138 Bologna (BO)]

Francesco Giuseppe Materazzi [Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum – University of Bologna, Bologna, Italy] [Montecatone Rehabilitation Institute, Imola (BO), Italy]

Background and aims

Low back pain (LBP) is a common and disabling symptom in persons with Parkinson’s Disease (PwPD), resulting from complex interactions between neurodegeneration, sensory dysfunction, and motor impairments. Effective management requires personalized, multimodal physiotherapy addressing biomechanical, neuromuscular, and neuroplastic factors. The aim of the present scoping review is to explore current evidence on physiotherapy interventions for LBP in Parkinson’s disease.

Methods

This scoping review was performed and reported according to the PRISMA-ScR guidelines. MEDLINE, Embase, Scopus, Cochrane Library and PEDro were searched up to May 23rd 2025. To be included, studies must involve participants diagnosed with PD at any stage, describe or evaluate at least one physiotherapy or physical intervention, and assess LBP as an outcome. There were no restrictions on study design; records were excluded if they were not published in Italian or English. Data extraction was performed using RAYYAN QCRI online software by two blinded reviewers; a third one was involved in case of disagreements.

Results

A total of 6832 records were obtained by the bibliographic search; after deleting duplicates, the remaining 4598 citations were screened by two blinded reviewers. Eight studies met the eligibility criteria: 3 RCTs, 2 case reports, 1 feasibility study and 2 RCT Protocol. 

Most interventions focused on exercise-based approaches aimed at enhancing postural alignment, mobility, and pain management. Studies evaluating pilates, yoga, postural re-education, and combined corrective exercise programs reported notable improvements in balance, functional capacity, and flexibility. Overall, improvements in pain, trunk mobility, and postural control were frequently reported. However, methodological heterogeneity limited comparison across studies.

Conclusion

Most of the available studies in literature discuss pain but do not focus on LBP specifically. The results of this scoping review suggest that LBP in PwPD is often underestimated in rehabilitation, with poorly understood neurophysiology and physiotherapy approaches remain unclear and inconsistent. 

Furthermore, the results of this scoping review should be interpreted with caution due to the high heterogeneity of intervention, study designs, and outcome measures made direct comparison challenging. This review highlights the need for more knowledge of LBP neurophysiopathology in PwPD and standardized methodologies to better assess and compare the effectiveness of physiotherapy interventions.

REFERENCES

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