Balance and falls in Parkinson's disease: A meta-analysis of the effect of exercise and motor training

Authors

  • Natalie E. Allen PhD,

    Corresponding author
    1. Neurological Rehabilitation Research Group, Faculty of Health Sciences, University of Sydney, Sydney, Australia
    • Neurological Rehabilitation Research Group, Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, NSW, Australia, 1825
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  • Catherine Sherrington PhD,

    1. Musculoskeletal Division, George Institute for Global Health, University of Sydney, Sydney, Australia
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  • Serene S. Paul BAppScPhty(Hons),

    1. Neurological Rehabilitation Research Group, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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  • Colleen G. Canning PhD

    1. Neurological Rehabilitation Research Group, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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  • Relevant conflicts of interest/financial disclosures: Natalie E. Allen received financial assistance from the University of Sydney Faculty of Health Sciences Postgraduate Research Scholarship, the George Burniston-Cumberland Foundation Fellowship, and the Parkinson's NSW Research Student Award. Catherine Sherrington receives salary funding from the National Health and Medical Research Council of Australia (NHMRC). Serene S. Paul receives financial assistance from a NHMRC PhD scholarship.

  • Full financial disclosures and author roles may be found in the online version of this article.

Abstract

This systematic review with meta-analysis aimed to determine the effects of exercise and motor training on the performance of balance-related activities and falls in people with Parkinson's disease. Sixteen randomized and quasi-randomized controlled trials that assessed the efficacy of exercise and/or motor training against no intervention or placebo intervention were included. The primary outcome measures were balance-related activity performance (15 trials) and falls (2 trials). The pooled estimate of the effect of exercise and motor training indicated significantly improved balance-related activity performance (Hedges' g, 0.33; 95% confidence interval, 0.11–0.55; P = .003), but there was no evidence of an effect on the proportion of fallers (risk ratio, 1.02; 95% confidence interval, 0.66–1.58, P = .94). Balance-related activity performance improved to a greater extent in the trials of programs involving highly challenging balance training, but the difference in effect sizes was not statistically significant (P = .166). Exercise and motor training can improve the performance of balance-related activities in people with Parkinson's disease. However, further research is required to determine if falls can be prevented in this population. © 2011 Movement Disorder Society

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