OBJECTIVES: To compare the effectiveness of an exercise programme with usual care in people with Parkinson's disease (PD) who have a history of falls. DESIGN: Pragmatic randomised controlled trial. SETTING: Recruitment was from three primary and four secondary care organisations, and PD support groups in South West England. The intervention was delivered in community settings. PARTICIPANTS: People with PD, with a history of two or more falls in the previous year, who were able to mobilise independently. INTERVENTION: 10 week, physiotherapy led, group delivered strength and balance training programme with supplementary home exercises (intervention) or usual care (control). MAIN OUTCOME MEASURE: Number of falls during the (a) 10 week intervention period and (b) the 10 week follow-up period. RESULTS: 130 people were recruited and randomised (64 to the intervention; 66 to usual care). Seven participants (5.4%) did not complete the study. The incidence rate ratio for falls was 0.68 (95% CI 0.43 to 1.07, p=0.10) during the intervention period and 0.74 (95% CI 0.41 to 1.33, p=0.31) during the follow-up period. Statistically significant between group differences were observed in Berg balance, Falls Efficacy Scale-International scores and recreational physical activity levels. CONCLUSIONS: The study did not demonstrate a statistically significant between group difference in falls although the difference could be considered clinically significant. However, a type 2 error cannot be ruled out. The findings from this trial add to the evidence base for physiotherapy and exercise in the management of people with PD. Trial registration ISRCTN50793425.
OBJECTIVES: To compare the effectiveness of an exercise programme with usual care in people with Parkinson's disease (PD) who have a history of falls. DESIGN: Pragmatic randomised controlled trial. SETTING: Recruitment was from three primary and four secondary care organisations, and PD support groups in South West England. The intervention was delivered in community settings. PARTICIPANTS: People with PD, with a history of two or more falls in the previous year, who were able to mobilise independently. INTERVENTION: 10 week, physiotherapy led, group delivered strength and balance training programme with supplementary home exercises (intervention) or usual care (control). MAIN OUTCOME MEASURE: Number of falls during the (a) 10 week intervention period and (b) the 10 week follow-up period. RESULTS: 130 people were recruited and randomised (64 to the intervention; 66 to usual care). Seven participants (5.4%) did not complete the study. The incidence rate ratio for falls was 0.68 (95% CI 0.43 to 1.07, p=0.10) during the intervention period and 0.74 (95% CI 0.41 to 1.33, p=0.31) during the follow-up period. Statistically significant between group differences were observed in Berg balance, Falls Efficacy Scale-International scores and recreational physical activity levels. CONCLUSIONS: The study did not demonstrate a statistically significant between group difference in falls although the difference could be considered clinically significant. However, a type 2 error cannot be ruled out. The findings from this trial add to the evidence base for physiotherapy and exercise in the management of people with PD. Trial registration ISRCTN50793425.
Authors: Colleen G Canning; Catherine Sherrington; Stephen R Lord; Jacqueline C T Close; Stephane Heritier; Gillian Z Heller; Kirsten Howard; Natalie E Allen; Mark D Latt; Susan M Murray; Sandra D O'Rourke; Serene S Paul; Jooeun Song; Victor S C Fung Journal: Neurology Date: 2014-12-31 Impact factor: 9.910
Authors: David Sparrow; Tamara R DeAngelis; Kathryn Hendron; Cathi A Thomas; Marie Saint-Hilaire; Terry Ellis Journal: J Neurol Phys Ther Date: 2016-01 Impact factor: 3.649
Authors: Janey Prodoehl; Miriam R Rafferty; Fabian J David; Cynthia Poon; David E Vaillancourt; Cynthia L Comella; Sue E Leurgans; Wendy M Kohrt; Daniel M Corcos; Julie A Robichaud Journal: Neurorehabil Neural Repair Date: 2014-06-24 Impact factor: 3.919
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