The physiatrist in Parkinson's multidisciplinary care: from orchestra member to orchestra director

Parkinson's disease (PD) is the fastest-growing neurodegenerative disorder worldwide. It is characterized by a heterogeneous spectrum of motor and non-motor symptoms that lead to progressive disability, which is often insufficiently addressed by pharmacological or surgical treatments alone. Optimal management of individuals living with PD, therefore, requires a multidisciplinary team approach that integrates comprehensive functional assessment with both pharmacological and non-pharmacological strategies. A person-centered framework is essential to ensure continuity, coherence, and tailored rehabilitation across disease stages. Within this context, physiatrists (rehabilitation medicine physicians) may play a pivotal role; however, their specific contributions to PD care remain insufficiently defined. This position paper presents the rationale, reviews the supporting evidence, and provides practical recommendations to strengthen and clarify the role of physiatrists in the comprehensive management of PD. We illustrate the versatile contributions of physiatrists using the metaphor of an orchestra, in which the physiatrist can play a valuable role as a member and, depending on local circumstances and the availability of possible alternatives, also as the director.