Article

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.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS