The effect of a balance exercise class on activity limitations in people with parkinson’s disease

SUMMARY Introduction Parkinson’s disease is the second most common neurodegenerative disease in the world today. Postural instability is one the four cardinal signs and causes reduced balance and can lead falls. Falls may have significant consequences. In addition PwPD experience increasing disability, reduced mobility, fear of falling and reduced quality of life. Pharmacology has been the cornerstone of treatment thus far, but may limited in treating postural instability. Increasing evidence suggests that physiotherapy and exercise improves balance and may reduce falls. There is limited evidence as to which type, intensity and frequency of exercise are most beneficial. Aims The aim is to assess the impact of a six week balance exercise class on activity limitations in PwPD. Objectives 1. Improve balanceas measured by the Brief BESTest 2. Reduce falls rates as measures by falls diary 3. Increasefunctional mobility as measured by the Timed Up and Go (TUG), Timed Up and Go-Cognitive (TUG-C) and Timed Up and Go-Manual (TUG-M). 4. Increase confidence and participation as measured by the Falls Efficacy Scale. 5. Improve QOL as measured by the Parkinson’s Disease Questionnaire - 39 (PDQ-39) Methods Single blind randomised control trial. Community dwelling PwPD. Hoehn and Yahr1-4. Independently mobile with and without an aid. Primary Outcome Measure was the Brief BESTtest. Secondary measures of interest included MDS-UPDRS (part 2 and part 3), Timed Up and Go, Timed Up and Go Cognitive, Timed Up and Go Manual, Falls Efficacy Scale, Parkinson’s Disease Questionnaire -39 Results Non-significant change in balance between groups, significant improvement in ADL section of MDS-UPDRS, no change in FOF or HROL Conclusions and Implications of findings A six week balance exercise programme did not have significant change in balance score. The duration of the study may not be of sufficient duration to show an impact.