Parkinson’s disease is a common, progressive neurological disease. Biofeedback can be added to physiotherapy, concurrent with activity, to provide people with knowledge of performance during intervention. However, the effectiveness of biofeedback in Parkinson’s disease is unclear. 

Is the addition of biofeedback to physiotherapy effective in improving activity limitations in people with Parkinson’s disease, compared with physiotherapy alone? 

A systematic review with meta-analysis of quasi-randomised or randomised trials was undertaken. Participants included people with idiopathic Parkinson’s disease. The intervention was biofeedback during activity training compared with the same amount of training without biofeedback. Outcome measures included measures of activity congruent with the activity trained. 

Nineteen studies comprising 578 participants were included in this review. The quality of included studies was good (average = 6 PEDro score). Given the diverse range of outcome measures reported across studies, results were presented as a pooled estimate of the standardised mean difference between groups (95% CI). Results showed a moderate, immediate effect of biofeedback in addition to physiotherapy compared with physiotherapy alone in all activities combined (SMD 0.35, 95% CI 0.07–0.63). There was a small, long-term effect of biofeedback in all activities (SMD 0.26, 95% CI 0.03–0.48). 

The addition of biofeedback to physiotherapy is more effective than physiotherapy alone, in improving activities in the short and long-term for people with Parkinson’s disease. 

Biofeedback in addition to physiotherapy should be implemented for people with Parkinson’s disease to maximise outcomes in improving activity limitations.