title: Trunk muscle exercises as a means of improving postural stability in people with Parkinson's disease: a protocol for a randomised controlled trial.
abstract: BACKGROUND
  Exercise has been shown to improve clinical measures of strength, balance and mobility, and in some cases, has improved symptoms of tremor and rigidity in people with Parkinson's disease (PD). However, to date, no research has examined whether improvements in trunk control can remedy deficits in dynamic postural stability in this population. The proposed randomised controlled trial aims to establish whether a 12-week exercise programme aimed at improving dynamic postural stability in people with PD; (1) is more effective than education; (2) is more effective when training frequency is increased; and (3) provides greater long-term benefits than education.
  
  
  METHODS
  Forty-five community-dwelling individuals diagnosed with idiopathic PD with a falls history will be recruited. Participants will complete baseline assessments including tests of cognition, vision, disease severity, fear of falling, mobility and quality of life. Additionally, participants will complete a series of standing balance tasks to evaluate static postural stability, while dynamic postural control will be measured during walking using head and trunk-mounted three-dimensional accelerometers. Following baseline testing, participants will be randomly-assigned to one of three intervention groups, who will receive either exercise once per week, exercise 3 days/week, or education. Participants will repeat the same battery of tests conducted at baseline after the 12-week intervention and again following a further 12-week sustainability period.
  
  
  CONCLUSIONS
  This study has the potential to show that low-intensity and progressive trunk exercises can provide a non-invasive and effective means for maintaining or improving postural stability for people with PD. Importantly, if the programme is noted to be effective, it could be easily performed by patients within their home environment or under the guidance of available allied health professionals.
  
  
  BACKGROUND
  The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613001175763).
authors.affiliation: School of Exercise Science, Australian Catholic University, Brisbane, Australia.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Hubble
authors.affiliation: School of Exercise Science, Australian Catholic University, Melbourne, Australia.
authors.forename: Geraldine A
authors.initials: GA
authors.lastname: Naughton
authors.affiliation: The University of Queensland, Centre for Clinical Research, Brisbane, Australia.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Silburn
authors.affiliation: School of Exercise Science, Australian Catholic University, Brisbane, Australia.
authors.forename: Michael H
authors.identifier: http://orcid.org/0000-0003-1817-7528
authors.initials: MH
authors.lastname: Cole
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D010300:Parkinson Disease / Q000503:physiopathology / Q000534:rehabilitation*; D004856:Postural Balance / Q000502:physiology*; D011788:Quality of Life; D013909:Thorax / Q000502:physiology
keywords: PUBLIC HEALTH