title: A Randomized Controlled Trial to Reduce Falls in People With Parkinson's Disease.
abstract: BACKGROUND
  Falls are common and disabling in people with Parkinson's disease (PD). There is a need to quantify the effects of movement rehabilitation on falls in PD.
  
  
  OBJECTIVE
  To evaluate 2 physical therapy interventions in reducing falls in PD.
  
  
  METHODS
  We randomized 210 people with PD to 3 groups: progressive resistance strength training coupled with falls prevention education, movement strategy training combined with falls prevention education, and life-skills information (control). All received 8 weeks of out-patient therapy once per week and a structured home program. The primary end point was the falls rate, recorded prospectively over a 12 month period, starting from the completion of the intervention. Secondary outcomes were walking speed, disability, and quality of life.
  
  
  RESULTS
  A total of 1547 falls were reported for the trial. The falls rate was higher in the control group compared with the groups that received strength training or strategy training. There were 193 falls for the progressive resistance strength training group, 441 for the movement strategy group and 913 for the control group. The strength training group had 84.9% fewer falls than controls (incidence rate ratio [IRR] = 0.151, 95% CI 0.071-0.322, P < .001). The movement strategy training group had 61.5% fewer falls than controls (IRR = 0.385, 95% CI 0.184-0.808, P = .012). Disability scores improved in the intervention groups following therapy while deteriorating in the control group.
  
  
  CONCLUSIONS
  Rehabilitation combining falls prevention education with strength training or movement strategy training reduces the rate of falls in people with mild to moderately severe PD and is feasible.
authors.affiliation: La Trobe University, Bundoora, Victoria, Australia m.morris@latrobe.edu.au.
authors.forename: Meg E
authors.initials: ME
authors.lastname: Morris
authors.affiliation: La Trobe University, Bundoora, Victoria, Australia.
authors.forename: Hylton B
authors.initials: HB
authors.lastname: Menz
authors.affiliation: The University of Melbourne, Carlton, Victoria, Australia.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: McGinley
authors.affiliation: Deakin University, Burwood, Victoria, Australia.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Watts
authors.affiliation: La Trobe University, Bundoora, Victoria, Australia.
authors.forename: Frances E
authors.initials: FE
authors.lastname: Huxham
authors.affiliation: Kingston Centre, Monash Health, Cheltenham, Victoria, Australia.
authors.forename: Anna T
authors.initials: AT
authors.lastname: Murphy
authors.affiliation: La Trobe University, Bundoora, Victoria, Australia.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Danoudis
authors.affiliation: La Trobe University, Bundoora, Victoria, Australia Kingston Centre, Monash Health, Cheltenham, Victoria, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Iansek
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D010353:Patient Education as Topic / Q000379:methods*; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D011788:Quality of Life; D055070:Resistance Training / Q000379:methods*; D016037:Single-Blind Method; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology
keywords: Parkinson’s disease; falls prevention; movement strategy training; physical therapy; progressive resistance strength training