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; Fitton, Carolyn

doi:10.1136/jnnp.2006.099333

Cited by 305 publications

(373 citation statements)

References 29 publications

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“…In line with our findings, which showed that 8 weeks of ABCT caused no significant difference in FOF, FOG, and risk of fall in PD patients, the results of a study by Allen (2011) showed that low-intensity exercises had no effects on fall prevention (57). Ashburn et al (2007) also showed that a 6-week, home-based protocol caused no changes in the risk of falling in a 6-month period (62). As previously reported, a 6-month history of fall can be regarded as a valid criterion for posture instability (63).…”

Section: Discussionsupporting

confidence: 78%

Effects of Alexander-Based Corrective Techniques on Forward Flexed Posture, Risk of Fall, and Fear of Falling in Idiopathic Parkinson’s Disease

et al. 2018

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Background: Patients with idiopathic Parkinson's disease (PD) have a flexed posture and are at an increased risk of falls. In addition, fear of falling (FOF) is among the main complaints of PD patients. To reduce the risk of falling, complex non-drug interventions are required, involving balance-challenging exercises with proper strength, along with posture alignment through corrective exercise interventions (Alexander techniques), which are often utilized to manage patients with PD and thoracic hyperkyphosis. Objectives: To investigate the effects of Alexander-based corrective techniques (ABCT) on forward flexed posture (thoracic hyperkyphosis and forward head posture), risk of falling, and FOF among idiopathic PD patients. Methods: In this interventional study, 26 male and female patients were randomly assigned to the experimental (n, 13) and control groups (n, 13). The subjects participated in a postural realignment program, consisting of 60-minute sessions over 8 weeks (3 sessions per week). Pre-and posttest evaluations were also carried out. Results:The results of paired t test regarding the effects of ABCT on the thoracic kyphosis angle (TKA), craniovertebral angle (CVA), falls efficacy scale-international (FES-I) score, freezing of gait (FOG), and functional reach test (FRT) score revealed a significant difference between the pre-and posttest stages in the control group (P = 0.05). In addition, the t test results showed a significant difference in the mean changes of TKA, FES-I score, FOG, and FRT score between the groups in the pre-and postintervention stages. The Pearson's correlation test showed that TKA had a significant positive correlation with FES-I and FOG in the groups. On the other hand, the results of Pearson's correlation test showed a significant negative correlation between TKA and FRT. Finally, the Pearson's correlation coefficient showed a significant positive correlation between CVA and FES-I, but not FRT in the groups. Conclusions: The findings of this study indicated that 8 weeks (24 sessions) of ABCT in the experimental group caused considerable improvements in TKA, CVA, FOF, FOG, and risk of fall in patients with PD.

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Section: Discussionsupporting

confidence: 78%

Effects of Alexander-Based Corrective Techniques on Forward Flexed Posture, Risk of Fall, and Fear of Falling in Idiopathic Parkinson’s Disease

et al. 2018

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“…Specific areas of change included physical activity, spiritual growth, and stress management. Ashburn et al reported on an RCT of a home-based exercise program to reduce falling in the population with Parkinson disease [26]. Participants were recruited from two National Health Service trusts in Dorset, United Kingdom, with well-defined inclusion and exclusion criteria.…”

Section: IVmentioning

confidence: 99%

Self-management in neurological disorders: Systematic review of the literature and potential interventions in multiple sclerosis care

Rae-Grant

Turner

Sloan

et al. 2011

JRRD

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Abstract-Our objective was to review the current body of evidence supporting the efficacy of self-management programs in individuals with multiple sclerosis (MS) and other chronic neurological conditions. We reviewed published literature using standardized search terms; examined self-management interventions in a variety of chronic neurological disorders, including MS; and classified studies using the evidence classification established by the American Academy of Neurology. We reviewed 527 abstracts, of which 39 met our inclusion criteria for evaluation. Of the 39 studies, 3 provided class I evidence assessing the efficacy of self-management interventions: a randomized controlled trial of a telephone counseling program for health promotion in MS, a home-based exercise program for reducing falls in people with Parkinson disease, and the comparison of a fitness center program versus a home-based exercise program for people with traumatic brain injury. The remaining studies provided additional support for self-management interventions with a lesser degree of methodologic rigor (class II, class III, or class IV evidence). We concluded that self-management strategies are applicable to chronic neurological diseases, but a need exists for more rigorous studies in this area. We provide recommendations for future intervention study methodologies with a specific emphasis on MS care.

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“…(placebo) 78 Ashburn 238 showed a non-significant trend towards a reduction in falls in patients with…”

Section: Tai Chimentioning

confidence: 99%

Preventing falls in older people

2015

Nursing Standard

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Preventing falls in older peopleSimon Conroy Falls are a major cause of injury fear of falling and death affecting 24% of older people annually. Falls have a major impact on hospital services, and are an important cause of carer strain and admission to long term care.Multifactorial interventions delivered to fallers are effective in reducing falls rates by 25%. However, no UK studies have evaluated the role of screening older people living in the primary care setting and offering those at high risk a falls prevention programme. This work describes two studies -the evaluation of a postal falls risk screening tool, and a randomised controlled trial assessing the benefits of offering a falls prevention programme to those identified as being at high risk.335 older people were recruited into the screening study, using a modified version of the Falls Risk Assessment Tool. The sensitivity was 79%, specificity 58%, positive predictive value 50% and the negative predictive value 83%.In the RCT, 364 community-dwelling older people at high risk of falls were randomised into a pragmatic, multicentre trial evaluating falls prevention programmes. 181 were allocated to the control group and 183 to the intervention.The primary outcome was the rate of falls; the adjusted IRR was 0.73 (0.51-1.03), p=0.071. There were no significant differences between the groups in terms of the proportion of fallers, recurrent fallers, medically verified falls, injurious falls, time to first fall or time to second fall. Nor were there significant differences in terms of institutionalisation, mortality, basic or extended activities of daily living, or fear of falling.Further work on the acceptability and implementation of falls prevention interventions is required, but subject to these conditions being met and a supportive cost-effectiveness analysis, the totality of the evidence suggests that screening and intervening for individuals at high risk of fall may be effective. 4 ACKNOWLEDGMENTS

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

Cited by 305 publications

References 29 publications

Effects of Alexander-Based Corrective Techniques on Forward Flexed Posture, Risk of Fall, and Fear of Falling in Idiopathic Parkinson’s Disease

Effects of Alexander-Based Corrective Techniques on Forward Flexed Posture, Risk of Fall, and Fear of Falling in Idiopathic Parkinson’s Disease

Self-management in neurological disorders: Systematic review of the literature and potential interventions in multiple sclerosis care

Preventing falls in older people

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