The effects of an exercise program on fall risk factors in people with Parkinson's disease: A randomized controlled trial

Abstract

This randomized controlled trial with blinded assessment aimed to determine the effect of a 6-month minimally supervised exercise program on fall risk factors in people with Parkinson's disease (PD). Forty-eight participants with PD who had fallen or were at risk of falling were randomized into exercise or control groups. The exercise group attended a monthly exercise class and exercised at home three times weekly. The intervention targeted leg muscle strength, balance, and freezing. The primary outcome measure was a PD falls risk score. The exercise group had no major adverse events and showed a greater improvement than the control group in the falls risk score, which was not statistically significant (between group mean difference = -7%, 95% CI -20 to 5, P = 0.26). There were statistically significant improvements in the exercise group compared with the control group for two secondary outcomes: Freezing of Gait Questionnaire (P = 0.03) and timed sit-to-stand (P = 0.03). There were statistically nonsignificant trends toward greater improvements in the exercise group for measures of muscle strength, walking, and fear of falling, but not for the measures of standing balance. Further investigation of the impact of exercise on falls in people with PD is warranted.

Balance and Gait Rehabilitation in Patients with Parkinson’s Disease

“…Findings from the trial showed a consistent trend of reduced rates of falls and injurious falls among participants in the exercise program, even though these differences were not significant. Similar findings were reported in the randomized control trial performed by Allen et al (Allen et al, 2010). Patients allocated to the exercise group attended a monthly exercise class run by one or two therapists and performed the remaining exercise sessions at home (three times a week) over a 6-month period.…”

“…However, no significant trends were found in the exercise group for measures of walking, strength, fear of falling and standing balance. Larger scale studies are warranted to explore this issue Allen et al, 2010;Canning et al, 2009) because to date no adequately powered studies have investigated exercises interventions aimed at reducing falls in patients with PD. Furthermore, the real cost effectiveness of exercise programs, from the health provider's perspective, has not been established.…”

Pilates Exercise and Functional Balance in Parkinson's Disease

“…Also it increases the muscle strength. Since reduction in the lower extremity strength move the center of gravity to in front of the ankle, which in turn causes imbalance and falls, the Pilates therefore seems to correct balance disorders by focusing on the functional improvement of core muscles and axial stability through creating neuromuscular adaptations [18,37,40,41]. Kibar et al (2015) found eight weeks of Pilates exercise to have beneficial effects on the static and dynamic balance and core muscle endurance in older adults, while they found no significant relationship between core muscle endurance and balance [42].…”

Augmented Feedback Using Visual Cues for Movement Smoothness during Gait Performance of Individuals with Parkinson’s Disease

“…Gait of patients with PD is significantly slower than that of age-matched healthy individuals and is characterized by decreased stride length and increased double-support periods [6][7][8][9][10] . However, cadence generally increases more in PD patients than in age-matched healthy people because of PD patients' shuffling or festinating gait 11,12) .…”