Physiotherapy management of neuroleptic induced Parkinsonism: four experienced physiotherapists discuss experience and evidence

Neuroleptic (antipsychotic) medication is used in the treatment of mental health psychoses which may compound conditions like schizophrenia. It is also employed in the management of challenging behaviour in dementia. Both typical and atypical drugs in this class are associated with serious side effects, one of which is Parkinsonism. This results from the drug’s action of blocking dopamine at receptor sites. Physiotherapy with this patient group has many challenges. This paper reports on a qualitative study which sought to explore these. A focus group was conducted with mental health physiotherapists (n=4) with experience of treating patients with neuroleptic induced Parkinsonism (NIP). Questioning explored the signs, symptoms and trajectory of NIP; physiotherapy assessment and management; multidisciplinary team working and possible enhancements to management. The focus group was audiotaped, transcribed verbatim and analysed thematically. Member checking was undertaken by supplying focus group participants with the full transcript and an outline of initial findings.