Is highly challenging and progressive balance training feasible in older adults with Parkinson's disease?
OBJECTIVE
To develop a highly challenging and progressive group balance training regime specific to Parkinson's disease (PD) symptoms and to investigate its feasibility in older adults with mild to moderate PD.


METHODS
Intervention study, before-after trial with a development and feasibility design.


METHODS
University hospital setting.


METHODS
Feasibility was evaluated in older adults (N=5; mean age, 72y; age range, 69-80y) with mild to moderate idiopathic PD.


METHODS
A balance training regime emphasizing specific and highly challenging exercises, performed 3 times per week for 12 weeks, was developed through discussion and workshops by a group of researchers and physiotherapists.


METHODS
Indicators of feasibility included attendance rate, safety (adverse events, physical function, and pain), participants' perceptions of the intervention (level of difficulty of the exercises, motivation level, and appreciation), and efficacy of the intervention (balance performance assessed with the Mini-Balance Evaluation Systems Test [Mini-BESTest]).


RESULTS
The incidence rate was high (93%) for attendance and low (1.2%) for adverse events. Ratings by the participants indicated progression throughout the training period. All participants considered the training motivational and stated that they would recommend it to others. The efficacy of the intervention measured with the Mini-BESTest showed that 4 out of 5 participants improved their balance performance.


CONCLUSIONS
These findings support the overall feasibility of this novel balance program in older adults with mild to moderate PD. However, to further evaluate the efficacy of the program, a larger randomized controlled trial is required.
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden. Electronic address: David.Conradsson.1@ki.se.
David
D
Conradsson
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
Niklas
N
Löfgren
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
Agneta
A
Ståhle
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
Erika
E
Franzén
D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000503:physiopathology / Q000534:rehabilitation*; D004856:Postural Balance / Q000502:physiology; D011788:Quality of Life; D016896:Treatment Outcome
Exercise; Feasibility studies; Parkinson disease; Rehabilitation