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Balance training in individuals with Parkinson's disease: Therapist-supervised vs. home-based exercise programme.
Gait Posture. 2017 06; 55:138-144.GP

Abstract

BACKGROUND

Poor locomotion and balance in Parkinson's disease (PD) often diminishes independence. Accordingly, gait is considered one of the most relevant rehabilitation outcomes, and home-based balance exercises might be a viable mode of exercise delivery for individuals with PD. However, research on PD interventions rarely indicate best practices to deliver exercises. Therefore, this study endeavoured to compare the efficacy of a home-based and therapist-supervised balance programme on gait parameters, dynamic balance, balance confidence and motivation in individuals diagnosed with PD.

METHODS

An experimental study design, including a cluster randomized convenience sample, of 40 participants with idiopathic PD (Hoehn and Yahr stage I-III; age: 65.0±7.7years). Participants were divided into a therapist-supervised (n=24) and home-based group (n=16). Groups received either eight weeks of balance training with an exercise therapist or a DVD. Outcome measures include the instrumented Timed-Up-and-Go, Functional Gait Analysis (FGA), Activity-specific Balance confidence (ABC) scale and Intrinsic Motivation Inventory (IMI).

RESULTS

Both groups improved in stride length (p<0.05). Similar FGA improved by 9% and 16% in the therapist-supervised and home-based group, respectively (p<0.01). Only the therapist-supervised group showed improvements in ABC (p=0.051), stride velocity (p=0.0006) and cadence (p=0.046) over the intervention; the latter two were also better compared to home-based (p<0.05). Furthermore the therapist-supervised group were more motivated (p=002).

CONCLUSION

The home-based balance programme was effective in improving some aspects of gait, albeit the programme supervised by an exercise therapist included somewhat more benefits after the intervention i.e. stride velocity and cadence in individuals with mild to moderate PD.

Authors+Show Affiliations

Department of Sport Science, Stellenbosch University, Movement Laboratory, Stellebosch, 7600, South Africa.Department of Sport Science, Stellenbosch University, Movement Laboratory, Stellebosch, 7600, South Africa. Electronic address: welman@sun.ac.za.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28445854

Citation

Atterbury, Elizabeth Maria, and Karen Estelle Welman. "Balance Training in Individuals With Parkinson's Disease: Therapist-supervised Vs. Home-based Exercise Programme." Gait & Posture, vol. 55, 2017, pp. 138-144.
Atterbury EM, Welman KE. Balance training in individuals with Parkinson's disease: Therapist-supervised vs. home-based exercise programme. Gait Posture. 2017;55:138-144.
Atterbury, E. M., & Welman, K. E. (2017). Balance training in individuals with Parkinson's disease: Therapist-supervised vs. home-based exercise programme. Gait & Posture, 55, 138-144. https://doi.org/10.1016/j.gaitpost.2017.04.006
Atterbury EM, Welman KE. Balance Training in Individuals With Parkinson's Disease: Therapist-supervised Vs. Home-based Exercise Programme. Gait Posture. 2017;55:138-144. PubMed PMID: 28445854.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Balance training in individuals with Parkinson's disease: Therapist-supervised vs. home-based exercise programme. AU - Atterbury,Elizabeth Maria, AU - Welman,Karen Estelle, Y1 - 2017/04/04/ PY - 2016/09/13/received PY - 2017/02/15/revised PY - 2017/04/02/accepted PY - 2017/4/27/pubmed PY - 2018/2/7/medline PY - 2017/4/27/entrez KW - Balance training KW - Dynamic balance KW - Exercise delivery KW - Gait KW - Parkinson’s disease SP - 138 EP - 144 JF - Gait & posture JO - Gait Posture VL - 55 N2 - BACKGROUND: Poor locomotion and balance in Parkinson's disease (PD) often diminishes independence. Accordingly, gait is considered one of the most relevant rehabilitation outcomes, and home-based balance exercises might be a viable mode of exercise delivery for individuals with PD. However, research on PD interventions rarely indicate best practices to deliver exercises. Therefore, this study endeavoured to compare the efficacy of a home-based and therapist-supervised balance programme on gait parameters, dynamic balance, balance confidence and motivation in individuals diagnosed with PD. METHODS: An experimental study design, including a cluster randomized convenience sample, of 40 participants with idiopathic PD (Hoehn and Yahr stage I-III; age: 65.0±7.7years). Participants were divided into a therapist-supervised (n=24) and home-based group (n=16). Groups received either eight weeks of balance training with an exercise therapist or a DVD. Outcome measures include the instrumented Timed-Up-and-Go, Functional Gait Analysis (FGA), Activity-specific Balance confidence (ABC) scale and Intrinsic Motivation Inventory (IMI). RESULTS: Both groups improved in stride length (p<0.05). Similar FGA improved by 9% and 16% in the therapist-supervised and home-based group, respectively (p<0.01). Only the therapist-supervised group showed improvements in ABC (p=0.051), stride velocity (p=0.0006) and cadence (p=0.046) over the intervention; the latter two were also better compared to home-based (p<0.05). Furthermore the therapist-supervised group were more motivated (p=002). CONCLUSION: The home-based balance programme was effective in improving some aspects of gait, albeit the programme supervised by an exercise therapist included somewhat more benefits after the intervention i.e. stride velocity and cadence in individuals with mild to moderate PD. SN - 1879-2219 UR - https://www.unboundmedicine.com/medline/citation/28445854/Balance_training_in_individuals_with_Parkinson's_disease:_Therapist_supervised_vs__home_based_exercise_programme_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0966-6362(17)30118-2 DB - PRIME DP - Unbound Medicine ER -