Exercise reduces falls in mild but not severe Parkinson's

SYDNEY, AUSTRALIA – An exercise-based intervention carried out at home with minimal supervision led to a significant reduction in falls in patients with mild but not severe Parkinson’s disease.

"The approach we took was to target three risk factors that exercise could potentially improve, that is, loss of muscle strength, poor balance, and freezing of gait," said lead author Colleen Canning, Ph.D., team leader for Parkinson’s disease research in the faculty of health sciences at the University of Sydney.

"The exercise program that we developed involved those three elements and was designed so that the participants did most of the exercise at home," she said in a poster presented at the international congress of Parkinson’s Disease and Movement Disorders.

In the study, Dr. Canning and her associates randomized 231 individuals with Parkinson’s disease to receive usual care or to participate in an exercise regimen involving 40-60 minutes of exercise three times a week for 6 months (Mov. Dis. 2013;28 [Suppl. 1]:442).

The intervention involved a range of balance, stepping, and strengthening exercises using weighted vests, as well as cueing using a metronome to overcome freezing. Around 10% of the exercise sessions were supervised by a physiotherapist.

There was a statistically nonsignificant 27% reduction (incidence rate ratio [IRR] = 0.73; 95% confidence interval [CI], 0.45-1.17; P = .18) in the incidence of falls between the intervention and control group, Dr. Canning said.

However, a subgroup analysis based on disease severity revealed a significant 69% reduction in the risk of falls among patients with lower disease severity (IRR = 0.31; 95% CI, 0.15-0.62; P less than .001), while there was a nonsignificant increase in the risk of falls in the higher–disease severity subgroup.

At the same time, there were significant improvements favoring the intervention group as a whole in a range of mobility and psychological functions, including the Short Physical Performance Battery, sit to stand, fear of falling, affect, and health and well-being measures.

The researchers also presented data on adherence to the program, showing that participants completed a mean of 72% of the prescribed exercise sessions, although this was based on patient self-report.

Patients with shorter disease duration, less bodily pain, better standing balance, and better perceived well-being and health were more likely to adhere to the exercise regimen. Disease severity and past falls did not significantly predict adherence, Dr. Canning noted.

"Our results suggest that this particular program has the potential to be quite an effective method of reducing falls in people with lower disease severity," she said in an interview. "This is an important finding because that’s the group that often doesn’t get offered exercise because they don’t have major motor difficulties early on."

There were no relevant conflicts of interest declared.

SYDNEY, AUSTRALIA – An exercise-based intervention carried out at home with minimal supervision led to a significant reduction in falls in patients with mild but not severe Parkinson’s disease.

"The approach we took was to target three risk factors that exercise could potentially improve, that is, loss of muscle strength, poor balance, and freezing of gait," said lead author Colleen Canning, Ph.D., team leader for Parkinson’s disease research in the faculty of health sciences at the University of Sydney.

"The exercise program that we developed involved those three elements and was designed so that the participants did most of the exercise at home," she said in a poster presented at the international congress of Parkinson’s Disease and Movement Disorders.

In the study, Dr. Canning and her associates randomized 231 individuals with Parkinson’s disease to receive usual care or to participate in an exercise regimen involving 40-60 minutes of exercise three times a week for 6 months (Mov. Dis. 2013;28 [Suppl. 1]:442).

The intervention involved a range of balance, stepping, and strengthening exercises using weighted vests, as well as cueing using a metronome to overcome freezing. Around 10% of the exercise sessions were supervised by a physiotherapist.

There was a statistically nonsignificant 27% reduction (incidence rate ratio [IRR] = 0.73; 95% confidence interval [CI], 0.45-1.17; P = .18) in the incidence of falls between the intervention and control group, Dr. Canning said.

However, a subgroup analysis based on disease severity revealed a significant 69% reduction in the risk of falls among patients with lower disease severity (IRR = 0.31; 95% CI, 0.15-0.62; P less than .001), while there was a nonsignificant increase in the risk of falls in the higher–disease severity subgroup.

At the same time, there were significant improvements favoring the intervention group as a whole in a range of mobility and psychological functions, including the Short Physical Performance Battery, sit to stand, fear of falling, affect, and health and well-being measures.

The researchers also presented data on adherence to the program, showing that participants completed a mean of 72% of the prescribed exercise sessions, although this was based on patient self-report.

Patients with shorter disease duration, less bodily pain, better standing balance, and better perceived well-being and health were more likely to adhere to the exercise regimen. Disease severity and past falls did not significantly predict adherence, Dr. Canning noted.

"Our results suggest that this particular program has the potential to be quite an effective method of reducing falls in people with lower disease severity," she said in an interview. "This is an important finding because that’s the group that often doesn’t get offered exercise because they don’t have major motor difficulties early on."

There were no relevant conflicts of interest declared.

SYDNEY, AUSTRALIA – An exercise-based intervention carried out at home with minimal supervision led to a significant reduction in falls in patients with mild but not severe Parkinson’s disease.

"The approach we took was to target three risk factors that exercise could potentially improve, that is, loss of muscle strength, poor balance, and freezing of gait," said lead author Colleen Canning, Ph.D., team leader for Parkinson’s disease research in the faculty of health sciences at the University of Sydney.

"The exercise program that we developed involved those three elements and was designed so that the participants did most of the exercise at home," she said in a poster presented at the international congress of Parkinson’s Disease and Movement Disorders.

In the study, Dr. Canning and her associates randomized 231 individuals with Parkinson’s disease to receive usual care or to participate in an exercise regimen involving 40-60 minutes of exercise three times a week for 6 months (Mov. Dis. 2013;28 [Suppl. 1]:442).

The intervention involved a range of balance, stepping, and strengthening exercises using weighted vests, as well as cueing using a metronome to overcome freezing. Around 10% of the exercise sessions were supervised by a physiotherapist.

There was a statistically nonsignificant 27% reduction (incidence rate ratio [IRR] = 0.73; 95% confidence interval [CI], 0.45-1.17; P = .18) in the incidence of falls between the intervention and control group, Dr. Canning said.

However, a subgroup analysis based on disease severity revealed a significant 69% reduction in the risk of falls among patients with lower disease severity (IRR = 0.31; 95% CI, 0.15-0.62; P less than .001), while there was a nonsignificant increase in the risk of falls in the higher–disease severity subgroup.

At the same time, there were significant improvements favoring the intervention group as a whole in a range of mobility and psychological functions, including the Short Physical Performance Battery, sit to stand, fear of falling, affect, and health and well-being measures.

The researchers also presented data on adherence to the program, showing that participants completed a mean of 72% of the prescribed exercise sessions, although this was based on patient self-report.

Patients with shorter disease duration, less bodily pain, better standing balance, and better perceived well-being and health were more likely to adhere to the exercise regimen. Disease severity and past falls did not significantly predict adherence, Dr. Canning noted.

"Our results suggest that this particular program has the potential to be quite an effective method of reducing falls in people with lower disease severity," she said in an interview. "This is an important finding because that’s the group that often doesn’t get offered exercise because they don’t have major motor difficulties early on."

There were no relevant conflicts of interest declared.