Study ID	Intervention	Outcome Measurement Utilized	Results
Bello 2011	1. NUCCA chiropractic technique	Patient subjective report	Patient reported that her fatigue, depression, and resting tremor in left hand had gone away. She also reported that her coping skills had returned, all tightness in her muscles had ceased, and she had regained use of her left arm and leg. Patient still had rigidity in her third left toe on occasion.[@227718]
Bova 2013	1. Blue lensed glasses 2. Vibration therapy 3. Mirror imaging 4. Cross-crawl exercises 5. Chiropractic manipulation	Parkinson’s Disease Questionnaire	PDQ was 15 at time of intake and 9 at the end of 2 months of treatment. Patient had improvement in his writing ability, improved posture, reduction of a subconscious leftward lean, reduction in anterior flexion by 10 degrees, and patient began walking without assistance from his walker.[@227716]
Bredin 2015	1. Diversified chiropractic technique	Patient subjective report	Patient reported an improvement in balance and that his symptoms only began improving once he began chiropractic care. Patient continued to take Disipal medication during treatment.[@227719]
Chung 2011	1. NUCCA chiropractic technique	Patient subjective report	Subjective report of improvement in 60% weakness, 50% in tremors, and 0% in rigidity after one month of treatment. After three months, there was improvement in 50% weakness, 60% tremors, and 30% in rigidity. Six months of treatment resulted in 70% improvement in mobility and a decrease in the number of falls the patient had been experiencing.[@227720]
DiFrancisco-Donoghue 2016	1. Osteopathic manipulative medicine	1. Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) 2. Sensory Organization Test (SOT) 3. Mini-Balance Evaluation System Test	Study began with 11 subjects but only 9 completed the study. Patients were split into two groups with 6 receiving OMM for the first 6 weeks then counseling for the next 6 weeks. The other 5 received counseling first then OMM. SOT had no statistical significance but there was an increase in the overall composite score. The Mini-BEST had no apparent trend in changes for pre to post intervention of either of the groups, but there was improvement. The MDS-UPDRS showed more improvement in the pre to post OMM than from the control. The treatment effect was statistically significant in the group receiving control for the first 6 weeks then OMM for the following 6 weeks.[@227721]
Elster 2004	1. Upper cervical chiropractic technique	Patient subjective report	Study composed of 37 patients, with 7 patients not included who discontinued the study. Out of the 37, 34 reported improvement: 16 were substantial, 8 were moderate, and 11 were minor. Three cases showed no change. Treatment ranged for 1 to five years with no symptom progressions reported in any of the 37 patients.[@227722]
Elster 2000	1. Upper cervical chiropractic technique	UPDRS	Patient reported a return of his balance and being able to ride his bike once again. UPDRS was taken originally with a rating of 32/74 as an on/off stage of when his medication was working and was not working respectively. Week 4 scores were 20/56 and the final score taken at 12 weeks was 13/47. There was a 43% overall improvement between the beginning and final UPDRS scores.[@227723]
Friedman 2017	1. Upper cervical chiropractic technique	Patient subjective report	Patient originally complained of right-sided tremors, memory loss, balance issues, constant leg pain, occasional poor circulation, decreased muscular strength, and the need for a walker. After initial adjustment, patient no longer needed a walker for assistance and his tremors were decreased. Patient was seen for 6 months and reported his symptoms appeared to be regressing and decreasing; he mentioned that he was now taking half of the Levodopa he was originally taking.[@227724]
Landry 2012	1. Upper cervical chiropractic technique	1. SF-36 2. PDQ-39	PDQ-39 had a decrease in score (a sign of a better quality of life) in mobility, emotional well-being, stigma, cognitive impairment, and bodily discomfort. There was an increase in score for activities of daily living. There was no change in social support or communication scores which were both 0% pre and post. SF-39 had an increase in score (a higher percentage shows a better quality of life) for physical component summary, mental component summary, bodily pain, physical functioning, and mental health. The score for general health remained unchanged.[@227725]
Malachowski 2011	1. Upper cervical chiropractic technique	Neurological exam	Patient received a neurological evaluation on intake then was re-evaluated at 12 weeks. He showed a decrease in positive neurological tests of the following: CN VII, dysmetria, and Rhomberg. Dysmetria was originally positive bilaterally, but post-test was positive on the left and negative on the right. Patient also reported being able to rise from a sitting to standing position more easily and being able to hold his head up to look at people while ambulating.[@227726]
Malachowski 2014	1. Upper cervical chiropractic technique	UPDRS	Three patients were involved in the study. Patient one had an intake UPDRS score of 25 and received care for three months with a UPDRS score of 15 taken at month 2. Patient two had an intake score of 27 and received care for 6 months with an updated score of 15 at month 5. Patient three had an intake score of 39, receiving care for 3 years and an updated score of 16 at 36 months.[@227727]
Norton 2013	1. Activator Method 2. Postural exercises	Objective range of motion measurements	Patient had symptoms that included resting tremors in her hands, fatigue, lack of motion in the cervical and lumbar spine with associated neck pain and stiffness and lower back pain. Patient was adjusted eleven times over the course of sixty-day treatment plan; at the end of the care plan, patient reported an improvement in motor abilities and a decrease in the frequency of tremors. The decrease in tremors occurred prior to the beginning of prescription medication, meaning the reduction in symptoms could have occurred because of the medication.[@227728]
Shapiro 2012	1. Chiropractic Biophysics technique	Patient subjective report and objective findings	Patient’s range of motion was taken during the assessment yielding the following findings: ROM: Cervical- Flexion 40o, Extension 25 o , RLF Flexion 10 o, LLF 5o, R/L Rotation 65 o. Lumbar- ranges of motion were the following: Flex 65 o, Ext 15 o, RLF 10 o, LLF 10 o, R/L Rot 10 o. MMT: 2/5 muscle weakness: neck extensors right and left l cervical lateral flexors trunk flexors/trunk extensors DTRs: All reported as either absent (0) or somewhat diminished (1+). Positive orthopedic tests: Cervical compression Shoulder compression Jackson’s compression Max cervical compression Minor’s sign Patrick’s Milgram’s Ely’s Yoman’s. Patient received 3 visits a week for 12 weeks before tests were reperformed. Post treatment findings: ROM: Cervical- Flexion 40o, Extension 34 o , RLF Flexion 25 o, LLF 25o, R/L Rotation 70o. Lumbar- ranges of motion were the following: Flex 70o, Ext 10o, RLF 20 o, LLF 20 o, R/L Rot 15 o. MMT: 5/5 muscles: neck extensors and flexors left lateral cervical flexors trunk flexors 4/5: muscles: R lateral neck flexors Trunk extensors DTRs: All reported as normal (2+) Positive orthopedic tests: R. max cervical compression R SLR Patrick’s Yeoman’s Patient also reported the following improvements: neck pain 30%, double vision 50%, lack of energy 40%, unexplained weight loss 20%, right hand weakness 40%, bilateral knee pain 50%, low back pain 50%, left hip pain 90%, bilateral calf cramping 80%, bladder leakage 50%, erectile dysfunction 30%.[@227729]
Wells 1999	1. Osteopathic manipulative medicine	Gait analysis	Twenty total patients participated with ten as a sham group and ten as a treatment group. There was also eight people as a control group in the study. All patients were required to undergo a 10-hour washout of their medication. Gait analysis was taken of stride length, cadence, shoulder velocity, arm movement velocity, wrist movement velocity, and lower limb velocity of hip, knee, and ankle. Analysis was taken prior and immediately after the adjustment or sham adjustment. The Parkinson’s patients showed significant increases in gait parameters related to stride and velocity for the upper and lower limbs compared with their pretreatment values. Cadence increases slightly but not significantly. The normal and sham-treated patients had now significant changes compared to their pretreatment values.[@227730]