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J Neurol Neurosurg Psychiatry 78:678-684 doi:10.1136/jnnp.2006.099333
  • Paper

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

  1. Ann Ashburn1,
  2. Louise Fazakarley1,
  3. Claire Ballinger2,
  4. Ruth Pickering3,
  5. Lindsay D McLellan1,
  6. Carolyn Fitton1
  1. 1School of Health Professions and Rehabilitation Sciences, University of Southampton, Southampton General Hospital, Southampton, UK
  2. 2Faculty of Health and Social Care, London South Bank University, London, UK
  3. 3School of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
  1. Correspondence to:
 Professor Ann Ashburn
 Rehabilitation Research Unit, School of Health Professions and Rehabilitation Sciences, University of Southampton, Level E, Centre Block, Mailpoint 886, Southampton General Hospital, Tremona Rd, Southampton SO16 6YD, UK; ann{at}soton.ac.uk
  • Received 3 June 2006
  • Accepted 5 October 2006
  • Revised 5 October 2006
  • Published Online First 21 November 2006

Abstract

Objective: To evaluate the effectiveness of a personalised home programme of exercises and strategies for repeat fallers 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 12 months and with intact gross cognitive function were invited to participate in this randomised controlled trial. Usual care was compared with a personalised 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 lower 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 = 0.004) and 6 months (p = 0.007). 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.

Footnotes

  • Published Online First 18 December 2006

  • Funded by: Action Medical Research, John and Lucille Van Geest Foundation.

  • Competing interests: None.

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