A Randomized Controlled Trial to Reduce Falls in People With Parkinson’s Disease

Falls are an inevitable part of the degenerative process of Parkinson’s disease (PD) and therefore it is important to quantify the effects of rehabilitation on falls in PD. The study achieved this through evaluating two physiotherapy interventions aimed at reducing falls. 210 persons with Parkinson’s were randomised into three groups: progressive resistance strength training coupled with falls prevention education, movement strategy training combined with falls prevention education, and life-skills information (control). All received 8 weeks of out-patient therapy once per week and a structured home program. The primary outcome measure was falls rate over a 12 months with secondary measures being walking speed, disability, and quality of life. A total of 1547 falls were reported for the trial. The falls rate was higher in the control group compared with the groups that received strength training or strategy training. There were 193 falls for the progressive resistance strength training group, 441 for the movement strategy group and 913 for the control group. The strength training group had 84.9% fewer falls than controls (incidence rate ratio [IRR] = 0.151, 95% CI 0.071-0.322, P < .001). The movement strategy training group had 61.5% fewer falls than controls (IRR = 0.385, 95% CI 0.184-0.808, P = .012). Disability scores improved in the intervention groups following therapy while deteriorating in the control group.

In conclusion rehabilitation combining falls prevention education with strength training or movement strategy training reduces the rate of falls in people with mild to moderately severe PD and is feasible.