Highlights
- •We conducted a randomized controlled trial on parkinsonian nonfallers.
- •Participants received 8-week task- and context-specific balance training.
- •Participants practiced fall-prone activities in both indoor and outdoor environments.
- •Dynamic balance and functional performance were enhanced up to 6-month follow-up.
- •Balance training has reduced the number of injurious fallers.
Abstract
Objectives
To investigate the short- and long-term effects of a task- and context-specific balance
training program on dynamic balance and functional performance, and to explore the
effects on preventing total and injurious falls in parkinsonian nonfallers.
Design
A randomized controlled trial with group allocation single-blinded to the assessor.
Setting
Community centers, malls, and outdoor parks.
Participants
Nonfallers with Parkinson disease (PD) (N=70; mean age ± SD, 61.2±8.8y) randomly assigned
to either a balance (BAL) group (n=32) or a control (CON) group (n=38).
Interventions
The BAL group received 4 weeks of indoor and 4 weeks of outdoor balance training (with
a 2-h session per week). The CON group received 8 weeks of upper limb training at
the same dosage. Both groups were instructed to perform 3 hours of home exercise weekly
posttraining.
Main Outcome Measures
(1) Dynamic balance performance: Mini-Balance Evaluation Systems Test (Mini-BESTest);
(2) Functional performance: functional reach (FR), 5 times sit-to-stand (FTSTS), 1-leg-stance
(OLS), Timed Up and Go (TUG), and dual-task TUG tests; (3) Fall-related outcomes:
ratios of total nonfallers to fallers and noninjurious fallers to injurious fallers,
total and injurious fall rates, times to first falls and injurious falls.
Results
Sixty-eight participants completed training. A total of 7 patients (10%) withdrew
before the 6-month follow-up, but not because of any adverse effects. At immediate
and 6 months posttraining, the BAL group showed significantly greater improvements
(from baseline) than the 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 (all P<.05). The number of injurious fallers was significantly lower in the BAL group at
6-month follow-up.
Conclusions
This task- and context-specific balance training program improved the dynamic balance
and fall-prone functional performance of PD nonfallers for up to 6 months after training.
The BAL group showed a reduction in injurious fallers.
Keywords
List of abbreviations:
BAL (balance), CON (control), FR (functional reach), FTSTS (5 times sit-to-stand), FU6m (6-month follow-up), Mini-BESTest (Mini-Balance Evaluation Systems Test), OLS (1-leg stance), PD (Parkinson disease), TUG (Timed Up and Go)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 20, 2015
Footnotes
Supported by the Hong Kong Parkinson's Disease Foundation (grant no. 8-ZH89).
Clinical Trial Registration No.: NCT01799681.
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
