A Selective Corrective Exercise to Decrease Falling and Improve Functional Balance in Idiopathic Parkinson’s Disease

Abstract

Background:Posture instability and unsteady gait disorders in Parkinson’s Disease (PD) usually contribute to fall-related fractures. Fall-related trauma in PD is the most common reason for injury. Despite providing modern care for PD patients (PP) in the recent years, anti-PD drugs have no effect on falling. There is an urgent need to administer exercise interventions to reduce falls and related injuries in the rehabilitation program of PP.Objectives:To explore the effect of a selective 10-week corrective exercise with an emphasis on gait training activities (GTA) on the number of falls (NOFs), fear of falling, functional balance, timed up and go (TUG) test among PD patients.Patients and Methods:A purposeful sampling was performed on PP who had fallen or were at risk of falling in 2014. The study intervention consisted of a 10-week (3 sessions each week, each lasting 60 min) corrective exercise program. Participants were randomly allocated to control and two exercise groups; the exercise group with balance pad (EGBP) or exercise group with no balance pad (EGNBP). The analysis of variance (ANOVA) and paired t-test were used for comparison between the groups (P ≤ 0.05).Results:Administrating a selective corrective exercise in exercise group with balance pad (EGBP) showed a significant difference in number of falls (NOF), Fall Efficacy Scale-international (FES-I), Berg balance scale (BBS) (and timed up and go) TUG (P = 0.001); while administrating the same exercise in exercise group with no balance pad (EGNBP) showed no significant difference in NOF (P = 0.225) and a significant difference in FES-I (P = 0.031), BBS (P = 0.047) and TUG (P = 0.012). The control group showed no significant difference in each of the dependent variables.Conclusions:Performing a selective corrective exercise on balance pad improves falling and functional balance in idiopathic PD.

Functional outcomes of an integrated Parkinson's Disease Wellbeing Program

“…Postural instability is a cardinal feature of PD that improves with pharmacotherapy in milder disease stages but becomes less responsive as the disease progresses . Our patient cohort had high BBS scores consistent with an overall low risk of falling . Despite this, a prior history of 1 or more falls was common.…”

The Effect of a Selective Pilates Program on Functional Balance and Falling Risk in Patients with Parkinson’s Disease

“…However, they require safety monitoring and are equipment-dependent. Research on alternative forms of exercise that could improve balance, gait, and function in patients with PD is scarce [12][13][14][15]. On balance, alternative physical therapies are worthy of consideration when selecting treatment options for people with this common chronic disease [7].…”

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

“…Some studies have established the beneficial effects of balance exercises on the prevention of idiopathic PD (31,61). 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).…”

“…Each session included 10 minutes of warm-up and stretching exercises, 40 minutes of postural realignment exercises, and 10 minutes of cooling down and stretching exercises (30). The postural realignment consisted of walking in different directions, static/dynamic marching, tandem walking (31), and ADLs. The standard guidelines regarding the frequency, volume, duration, intensity, and progression of exercises were applied (32,33).…”