- The physiotherapist-delivered PDSAFE intervention did not reduce risk for falls among patients with Parkinson’s disease overall, but possibly did among those with only moderate disease.
Why this matters
- High prevalence, morbidity of falls.
- 6-month rate of repeat falls: 61.5% in the intervention group, 55% in the control group (controlled OR, 1.21; P=.447).
- Outcomes favoring intervention:
- Near falls (OR, 0.67; P=.001).
- Balance (difference in Mini-BESTest score, 0.95 points; P=.009).
- Falls Efficacy Scale score (difference, 1.60 points; P=.026).
- Chair stand test time (12 vs 13 seconds; P=.041).
- Possible benefit of intervention (P for interaction=.009 to .089) in reducing falls for patients:
- Not having freezing of gait.
- Less/not impaired on Montreal Cognitive Assessment.
- With intermediate Unified Parkinson’s Disease Rating Scale score.
- Having 2-3 falls in the last year.
- UK multicenter randomized controlled trial among 474 patients with Parkinson’s disease (Hoehn and Yahr stage I-IV) experiencing ≥1 fall in the last year.
- Randomization: physiotherapist-delivered intervention (individually tailored, progressive home-based fall-avoidance strategy training program with balance, strengthening exercises) vs control (DVD about disease, single advice session).
- Main outcome: risk for repeat falling from self-report monthly diaries.
- Funding: National Institute for Health Research.
- Unclear generalizability.
- Lack of complete 12-month follow-up.