Parkinson's Disease
Conditions
Keywords
randomised controlled trial, postural balance, rehabilitation, exercise therapy, accidental falls
Brief summary
To determine whether the 8-week Hopeful Outdoor Parkinson's Exercise (HOPE) Program would be effective in improving balance performance, physical functions, gait parameter, balance confidence, health-related quality-of-life, disease-specific motor performance and fall-related outcomes in Parkinson's disease (PD) non-fallers and single fallers.
Detailed description
Previous studies demonstrated that multi-modal balance training program was effective in improving balance performance in people with PD. However they did not include all the balance domains and outdoor fall-prone activities have been overlooked. We designed a task- and context-specific balance training program based on the framework of the Balance Evaluation Systems Test (BESTest) to target all six balance domains including biomechanical constraints, stability limits and verticality, anticipatory postural adjustments, reactive postural responses, sensori-motor integration and dynamic gait control.
Interventions
BEHAVIORALan 8-week blended indoor-outdoor exercise program
stretching, strength and functional training, Balance Dance, Modified Wing Chun, Square stepping exercise, and fall-prone activities practice
BEHAVIORALan 8-week upper limb and hand exercise program
upper limb stretching and strengthening, hand agility exercises, knot tying and Chinese calligraphy
Sponsors
The Hong Kong Polytechnic University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
30 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* diagnosed with PD by a neurologist (Fahn and Elton, 1987); * aged 30 to 85 years; * at modified Hoehn and Yahr (H&Y) stage 1.5 to 3 (Hoehn and Yahr ,1967; Goetz et al., 2004); * able and willing to give written consent for participation in the study; * living at home in the community; * able to walk independently for 30 metres with or without an assistive device.
Exclusion criteria
* any neurological conditions other than PD; * significant musculoskeletal or cardiopulmonary diseases; * other disorders that may affect balance or locomotion; * taken any structured behavioral or exercise programs in the past 3 months * or they are receiving regular physical rehabilitation at present; * unstable condition on anti-parkinsonian medications; * surgical interventions for PD; * communication or cognitive deficits with mini-mental state examination, (MMSE) \<24/30 (Folstein et al., 1975); * a history of more than two falls in the previous 12 months.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Changes from baseline Balance Systems Evaluation Test total and subsection scores at post 4-week training, post 8-week training, 6- and 12-month follow-ups | 12 months after intervention |
Secondary
| Measure | Time frame |
|---|---|
| Changes from baseline timed-up-and-go time at post 4-week training, post 8-week training, 6- and 12-month follow-ups | 12 months after intervention |
| Changes from baseline five-times-sit-to-stand time at post 4-week training, post 8-week training, 6- and 12-month follow-ups | 12 months after intervention |
| Changes from baseline one-leg stance time at post 4-week training, post 8-week training, 6- and 12-month follow-ups | 12 months after intervention |
| Changes from baseline Activities-specific Balance Confidence Scale at post 4-week training, post 8-week training, 6- and 12-month follow-ups | 12 months after intervention |
| Changes from baseline Parkinson's disease Questionnaire (PDQ-39) at post 4-week training, post 8-week training, 6- and 12-month follow-ups | 12 months after intervention |
| Changes from baseline comfortable gait speed at post 4-week training, post 8-week training, 6- and 12-month follow-ups | 12 months after intervention |
| Changes from baseline dual task timed-up-and-go time at post 4-week training, post 8-week training, 6- and 12-month follow-ups | 12 months after intervention |
Other
| Measure | Time frame |
|---|---|
| Total and Injurious fall rates | 12 months after intervention |
| The time to first fall and time to first injurious fall | 12 months after intervention |
| Changes from baseline Movement Disorder Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS) III at post 4-week training, post 8-week training, 6-and 12-month follow-ups | 12 months after intervention |
| Ratios of total and injurious non-fallers to fallers | 12 months after intervention |
Countries
China
Outcome results
None listed