Protocol for a home-based integrated physical therapy program to reduce falls and improve mobility in people with Parkinson's disease.
BACKGROUND
The high incidence of falls associated with Parkinson's disease (PD) increases the risk of injuries and immobility and compromises quality of life. Although falls education and strengthening programs have shown some benefit in healthy older people, the ability of physical therapy interventions in home settings to reduce falls and improve mobility in people with Parkinson's has not been convincingly demonstrated.


METHODS
180 community living people with PD will be randomly allocated to receive either a home-based integrated rehabilitation program (progressive resistance strength training, movement strategy training and falls education) or a home-based life skills program (control intervention). Both programs comprise one hour of treatment and one hour of structured homework per week over six weeks of home therapy. Blinded assessments occurring before therapy commences, the week after completion of therapy and 12 months following intervention will establish both the immediate and long-term benefits of home-based rehabilitation. The number of falls, number of repeat falls, falls rate and time to first fall will be the primary measures used to quantify outcome. The economic costs associated with injurious falls, and the costs of running the integrated rehabilitation program from a health system perspective will be established. The effects of intervention on motor and global disability and on quality of life will also be examined.


CONCLUSIONS
This study will provide new evidence on the outcomes and cost effectiveness of home-based movement rehabilitation programs for people living with PD.


BACKGROUND
The trial is registered on the Australian and New Zealand Clinical Trials Registry (ACTRN12608000390381).
Department of Physiotherapy, The University of Melbourne, Carlton, VIC 3010, Australia. m.morris@unimelb.edu.au
Meg E
ME
Morris
Clarissa
C
Martin
Jennifer L
JL
McGinley
Frances E
FE
Huxham
Hylton B
HB
Menz
Nicholas F
NF
Taylor
Mary
M
Danoudis
Jennifer J
JJ
Watts
Sze-Ee
SE
Soh
Andrew H
AH
Evans
Malcolm
M
Horne
Peter
P
Kempster
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D010300:Parkinson Disease / Q000453:epidemiology* / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D015995:Prevalence; D018570:Risk Assessment; D016896:Treatment Outcome; D014739:Victoria / Q000453:epidemiology