Task- and Context-specific Balance Training Programme Enhances Dynamic Balance and Functional Performance in Parkinsonian Non-fallers: A Randomised Controlled Trial with Six-month Follow-up

The objective of this article was to investigate the short- and long-term effects of a task- and context-specific balance training programme on dynamic balance and functional performance, and to explore the effects on preventing total and injurious falls in Parkinsonian (PD) non-fallers. This was achieved through an RCT including 70 PD fallers randomised into the control (n=38) and balance (n=32) groups. The balance group received four weeks indoor and four weeks outdoor balance training (with a two-hour session/week). The control group received eight weeks of upper limb training at the same dosage. Both groups were instructed to perform 3 hours home exercise weekly post-training. The balance performance was assessed using the following outcome measures; 1. Dynamic balance performance: Mini-BESTest; 2. Functional performance: functional reach (FR), five-time-sit-to-stand (FTSTS), one-leg-stance (OLS), time-up-and-go (TUG) and dual-task TUG tests; 3. Fall-related outcomes: ratios of total non-fallers to fallers and non-injurious fallers to injurious fallers, total and injurious fall rates, times to first falls and injurious falls. Sixty-eight participants completed training. A total of seven patients (10%) withdrew before the six-month follow-up, but not due to any adverse effects. At immediate and six-month post-training, BAL group showed significantly greater improvements (from baseline) than CON group in Mini-BESTest total scores, FR distances and OLS times, together with greater time reductions in FTSTS, TUG and dual-task TUG tests (allp<0.05). The number of injurious fallers was significantly lower in BAL group at six-month follow-up.

This task- and context-specific balance training programme improved the dynamic balance and fall-prone functional performance of PD non-fallers for up to six months after training. The BAL group showed a reduction in injurious fallers.