A randomised controlled trial of a home based exercise programme to reduce the risk of falling among people with Parkinson's disease

Ashburn, Ann; Fazakarley, Louise; Ballinger, Claire; Pickering, Ruth; McLellan, Lindsay D.; Fitton, Carolyn
July 2007
Journal of Neurology, Neurosurgery & Psychiatry;Jul2007, Vol. 78 Issue 7, p678
Academic Journal
Objective: To evaluate the effectiveness of a personalised home programme of exercises and strategies for repeat falters with Parkinson's disease (PD). Method: Patients with a confirmed diagnosis of idiopathic PD, independently mobile, living at home in the community, experiencing more than one fall in the previous 1 2 months and with intact gross cognitive function were invited to participate in this randomised controlled trial. Usual care was compared with a personolised 6 week, home based exercise and strategy programme. The primary outcomes were rates of falling at 8 weeks and 6 months. Whether participants had repeat fallen, nearly fallen or experienced injurious falls were also examined. Functional Reach, the Berg Balance Test, PD Self-assessment Scale and the Euro Quol were rated by a blinded assessor. Results: Participants were randomised to the exercise (n = 70) and control (n = 72) groups. There was a consistent trend towards lower fall rates in the exercise group at both 8 weeks and 6 months and tower rates of injurious falls needing medical attention at 6 months. Lower rates of repeat near falling were evident for the exercise group at 8 weeks (p=0.00) and 6 months (p=0.00). There was a positive effect of exercises at 6 months on Functional Reach (p=0.009) and quality of life (p=0.033). No significant differences were found on other secondary outcomes measures. Conclusion: There was a trend towards a reduction in fall events and injurious falls with a positive effect of exercises on near falls and quality of life.


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