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Open Access Highly Accessed Study protocol

Protocol for a home-based integrated physical therapy program to reduce falls and improve mobility in people with Parkinson’s disease

Meg E Morris13*, Clarissa Martin1, Jennifer L McGinley1, Frances E Huxham1, Hylton B Menz12, Nicholas F Taylor23, Mary Danoudis1, Jennifer J Watts14, Sze-Ee Soh1, Andrew H Evans5, Malcolm Horne6 and Peter Kempster7

Author affiliations

1 Department of Physiotherapy, The University of Melbourne, Carlton, VIC, 3010, Australia

2 Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Bundoora, VIC, 3086, Australia

3 Department of Physiotherapy, Faculty of Health Sciences, La Trobe University, Bundoora, VIC, 3086, Australia

4 Center for Health Economics, Monash University, Building 75, Clayton, VIC, 3800, Australia

5 Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, 3052, Australia

6 Howard Florey Neurosciences Institute, The University of Melbourne, Parkville, VIC, 3010, Australia

7 Neurosciences Department, Monash Medical Centre, Clayton, VIC, 3168, Australia

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Citation and License

BMC Neurology 2012, 12:54  doi:10.1186/1471-2377-12-54

Published: 16 July 2012

Abstract

Background

The high incidence of falls associated with Parkinson’s disease (PD) increases the risk of injuries and immobility and compromises quality of life. Although falls education and strengthening programs have shown some benefit in healthy older people, the ability of physical therapy interventions in home settings to reduce falls and improve mobility in people with Parkinson’s has not been convincingly demonstrated.

Methods/design

180 community living people with PD will be randomly allocated to receive either a home-based integrated rehabilitation program (progressive resistance strength training, movement strategy training and falls education) or a home-based life skills program (control intervention). Both programs comprise one hour of treatment and one hour of structured homework per week over six weeks of home therapy. Blinded assessments occurring before therapy commences, the week after completion of therapy and 12 months following intervention will establish both the immediate and long-term benefits of home-based rehabilitation. The number of falls, number of repeat falls, falls rate and time to first fall will be the primary measures used to quantify outcome. The economic costs associated with injurious falls, and the costs of running the integrated rehabilitation program from a health system perspective will be established. The effects of intervention on motor and global disability and on quality of life will also be examined.

Discussion

This study will provide new evidence on the outcomes and cost effectiveness of home-based movement rehabilitation programs for people living with PD.

Trial registration

The trial is registered on the Australian and New Zealand Clinical Trials Registry (ACTRN12608000390381).

Keywords:
Parkinson’s disease; Accidental falls; Randomized controlled trial; Falls prevention