Interventions for preventing falls in Parkinson's disease

Allen, Natalie E.; Canning, Colleen G.; Almeida, Lorena Rosa S.; Bloem, Bastiaan R.; Keus, S.H.J.; Löfgren, Niklas; Nieuwboer, Alice; Verheyden, Geert; Yamato, Tiê Parma; Sherrington, Catherine

doi:10.1002/14651858.cd011574.pub2

Cited by 43 publications

(61 citation statements)

References 209 publications

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“…Supervision and modification of exercise interventions with PD individuals at a complex stage or with moderate or severe cognitive impairment requires specialist skills [ 221 ].…”

Section: Specific Clinical Populationsmentioning

confidence: 99%

“…Falls prevention exercise interventions should be integrated in general mobility and ADL rehabilitation [ 221 ].…”

Section: Specific Clinical Populationsmentioning

confidence: 99%

“…The effect of exercise on falls in older adults with PD that is more advanced (e.g. MDS-UPDRS motor score ≥ 34) and/or with substantial cognitive impairment is uncertain, but limited data indicate that minimally supervised exercise may increase the risk of falls [ 221 ].…”

Section: Specific Clinical Populationsmentioning

confidence: 99%

“…A higher level of supervision is necessary in older adults with intermediate cognitive impairment, as such individuals may not be able to follow a self-directed programme, and for safety [ 221 ].…”

Section: Specific Clinical Populationsmentioning

confidence: 99%

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World guidelines for falls prevention and management for older adults: a global initiative

et al. 2022

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Background falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present. Objectives to create a set of evidence- and expert consensus-based falls prevention and management recommendations applicable to older adults for use by healthcare and other professionals that consider: (i) a person-centred approach that includes the perspectives of older adults with lived experience, caregivers and other stakeholders; (ii) gaps in previous guidelines; (iii) recent developments in e-health and (iv) implementation across locations with limited access to resources such as low- and middle-income countries. Methods a steering committee and a worldwide multidisciplinary group of experts and stakeholders, including older adults, were assembled. Geriatrics and gerontological societies were represented. Using a modified Delphi process, recommendations from 11 topic-specific working groups (WGs), 10 ad-hoc WGs and a WG dealing with the perspectives of older adults were reviewed and refined. The final recommendations were determined by voting. Recommendations all older adults should be advised on falls prevention and physical activity. Opportunistic case finding for falls risk is recommended for community-dwelling older adults. Those considered at high risk should be offered a comprehensive multifactorial falls risk assessment with a view to co-design and implement personalised multidomain interventions. Other recommendations cover details of assessment and intervention components and combinations, and recommendations for specific settings and populations. Conclusions the core set of recommendations provided will require flexible implementation strategies that consider both local context and resources.

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“…Supervision and modification of exercise interventions with PD individuals at a complex stage or with moderate or severe cognitive impairment requires specialist skills [ 221 ].…”

Section: Specific Clinical Populationsmentioning

confidence: 99%

“…Falls prevention exercise interventions should be integrated in general mobility and ADL rehabilitation [ 221 ].…”

Section: Specific Clinical Populationsmentioning

confidence: 99%

Section: Specific Clinical Populationsmentioning

confidence: 99%

Section: Specific Clinical Populationsmentioning

confidence: 99%

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World guidelines for falls prevention and management for older adults: a global initiative

et al. 2022

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“…Large mechanical destabilising disturbances during walking (such as slips and trips) lead to most falls among community-dwelling older adults (Sheldon, 1960, Tinetti et al, 1988, Lord et al, 1993, Berg et al, 1997, Niino et al, 2000, Talbot et al, 2005, Crenshaw et al, 2017, McCrum, 2019. Interventions to reduce falls among older adults and clinical populations with balance impairment have received much attention in the literature, with multiple Cochrane reviews on the topic (Cameron et al, 2018, Hopewell et al, 2018, Williams et al, 2018, Denissen et al, 2019, Sherrington et al, 2019, Allen et al, 2022. Physical exercise is the most evidence-based approach for preventing falls, with challenging balance exercise among the most successful approaches (Hamed et al, 2018, Sherrington et al, 2019, Sibley et al, 2021.…”

Section: Introductionmentioning

confidence: 99%

Perturbation-based Balance Training: Principles, Mechanisms and Implementation in Clinical Practice

McCrum¹,

Bhatt²,

Gerards³

et al. 2022

Preprint

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Since the mid-2000s, perturbation-based balance training has been gaining interest as an efficient and effective way to prevent falls in older adults. It has been suggested that this task-specific training approach may present a paradigm shift in fall prevention. In this review, we discuss key concepts and common issues and questions regarding perturbation-based balance training. In doing so, we aim to provide a comprehensive synthesis of the current evidence on the mechanisms, feasibility and efficacy of perturbation-based balance training for researchers and practitioners. We address this in two sections: “Principles and Mechanisms” and “Implementation in Practice”. In the first section, definitions, task-specificity, adaptation and retention mechanisms and the dose-response relationship are discussed. In the second section, issues related to safety, anxiety, evidence in clinical populations (e.g., Parkinson’s disease, stroke), technology and training devices are discussed. Perturbation-based balance training is a promising approach to fall prevention. However, several fundamental and applied aspects of the approach need to be further investigated before it can be widely implemented in clinical practice.

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