21 November 2007
Ann Ashburn, Louise Fazakarley, Claire Ballinger, Ruth Pickering,
Lindsay D McLellan, and Carolyn Fitton
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.
