An exercise intervention to prevent falls in people with Parkinson's disease: a pragmatic randomised controlled trial. Issue 11 (19th August 2011)

• Record Type: Journal Article
• Authors: Goodwin, Victoria A; Richards, Suzanne H; Henley, William; Ewings, Paul; Taylor, Adrian H; Campbell, John L
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 82:Issue 11(2011)
• Page Start: 1232
• Page End: 1238
• Publication Date: 2011-08-19
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2011-300919
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : 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.