MDS 17th International Congress of Parkinson's Disease and Movement Disorders, Volume 28,
June 2013 Abstract Supplement
Movement Disorders 2013
Sydney, Australia June 16-20, 2013.
Exercise for falls prevention in Parkinson's disease: A randomised controlled trial
Canning , C.G., Sherrington , C., Lord , S.R., Close , J.C.T., Heller , G., Heritier , S., Howard , K., Allen , N.E., Paul , S.S., Murray , S.M., O'Rourke , S.D., Fung , V.S.C.
The primary aim was to determine the efficacy of exercise for falls prevention in people with Parkinson's disease (PD).
People with PD fall frequently. An exercise program targeting potentially remediable fall risk factors, ie, poor balance, reduced leg muscle strength and freezing of gait, was tested.
231 people with PD were randomised into a usual-care control group and an exercise group. The exercise group undertook 40-60 min exercise, 3 x wk for 6 mths. A physiotherapist supervised 10% of the exercise sessions. Primary outcomes were fall rates (analysed using the Poisson Inverse Gaussian model) and proportion of fallers during the intervention period. Secondary outcomes, taken at baseline and post-intervention by blinded assessors, were: balance, mobility, fear of falling, freezing of gait, health and well being, physical activity, affect and quality of life.
The exercise group had 467 falls and the control group had 810. There was no significant difference between groups in the rate of falls (IRR=0.73, 95%CI 0.45 to 1.17, p=0.18) or proportion of fallers (p=0.54). Pre-specified subgroup analysis revealed a significant interaction effect for disease severity. The low disease severity exercise subgroup showed a reduced rate of falls (IRR=0.31, 95%CI 0.15 to 0.62, p<0.001) and proportion of fallers (p=0.01), while the high disease severity exercise subgroup showed a trend towards an increased rate of falls (IRR=1.61, 95%CI 0.86 to 3.03, p=0.13) and proportion of fallers (p=0.07). There were significant differences in favour of the exercise group on the Short Physical Performance Battery, sit to stand, fear of falling, affect, and health and well being measures.
An exercise program targeting balance, strength and freezing of gait improved physical and psychological health but did not reduce falls overall. This program appears to be effective in reducing falls in people with mild PD but not severe PD.
To cite this abstract, please use the following information:
Canning, C.G., Sherrington, C., Lord, S.R., Close, J.C.T., Heller, G., Heritier, S., Howard, K., Allen, N.E., Paul, S.S., Murray, S.M., O'Rourke, S.D., Fung, V.S.C.; Exercise for falls prevention in Parkinson's disease: A randomised controlled trial [abstract]. Movement Disorders 2013;28 Suppl 1 :442