As far as we know, no interventions are used in the early phase of facilitative paratonia and oppositional paratonia. It is possible that in this phase when the risk of falling has increased, fall prevention can be used.

Interventions in practice

In the case of more severe oppositional paratonia, various interventions are used, such as supportive materials, PDL, botulin toxin injections, rocking movements (harmonic techniques), massage, warm water baths, and heat applications, snoezelen, and other techniques to promote relaxation. However, most interventions have not been scientifically studied for their effect on paratonia or have only been studied on a very limited scale, which means that convincing scientific evidence for all these interventions is lacking.

Tailored interventions

When an intervention is applied, it must be tailored to the goals that are set and that the effect of the intervention is properly and methodically monitored using valid and reliable measuring instruments.

Movement as medicine

There is promising evidence for a positive effect of exercise therapy in people with dementia on improving ADL and cognition. Furthermore, it has been shown that the care burden of informal caregivers is significantly reduced as a result of this exercise therapy, especially when the informal caregiver is involved in the exercise therapy. All in all, it is important to creatively search for possibilities for well-being and comfort, which are individually very different, in a multidisciplinary context together with the patient and the family.

Research agenda

In the last 10 years, our research group has been the only one in the world to study the phenomenon of paratonia, resulting in a consensus definition, a measuring instrument to measure paratonia, more insight into the pathogenesis and it has been demonstrated that passive movement has no added value in severe paratonia. However, there are still many questions. In a systematic review in 2020 we formulated the research agenda as follows;

  • More research is needed into the pathogenesis of paratonia.
  • Validation and improvement of the measuring instruments and techniques for assessing paratonia and its severity. It is also important to be able to detect changes over time to measure the effects of interventions.
  • Set up methodologically strong clinical trials to gain insight into the effects of interventions.