Home-based prescribed exercise improves balance-related activities in people with Parkinson’s disease and has benefits similar to centre-based exercise

A systematic review

Allyson Flynn, Natalie Allen, Sarah Dennis, Colleen Canning, Elisabeth Preston

Research output: Contribution to journalLiterature review

1 Downloads (Pure)

Abstract

Questions: In people with Parkinson's disease, does home-based prescribed exercise improve balance-related activities and quality of life compared with no intervention? Are the effects of home-based exercise similar to those of equivalent centre-based exercise? Design: Systematic review and meta-analysis of randomised and quasi-randomised controlled trials. Participants: Adults diagnosed with idiopathic Parkinson's disease. Intervention: Predominantly home-based prescribed exercise (defined as a minimum of two-thirds of the exercise being completed at home). The intervention had to primarily involve physical practice of exercises targeting gait and/or standing balance compared with either control (ie, usual care only, a sham intervention or no physiotherapy) or equivalent predominantly centre-based exercise. Outcome measures: The primary outcome was balance-related activities and the secondary outcomes were gait speed, Berg Balance Scale, Functional Reach test, and quality of life. Results: Sixteen trials met the inclusion criteria and all contributed to the meta-analyses. Twelve trials compared home-based prescribed exercise with control, and four trials compared home-based prescribed exercise with equivalent centre-based exercise. Home-based prescribed exercise improved balance-related activities (SMD 0.21, 95% CI 0.10 to 0.32) and gait speed (SMD 0.30, 95% CI 0.12 to 0.49), but not quality of life (SMD 0.11, 95% CI −0.01 to 0.23) compared with control. Home-based and centre-based exercise had similar effects on balance-related activities (SMD −0.04, 95% CI −0.36 to 0.27) and quality of life (SMD −0.08, 95% CI −0.41 to 0.24). Conclusion: Home-based prescribed exercise improves balance-related activities and gait speed in people with Parkinson's disease, and these improvements are similar to improvements with equivalent centre-based exercise. 

Original languageEnglish
Pages (from-to)189-199
Number of pages11
JournalJournal of Physiotherapy
Volume65
Issue number4
DOIs
Publication statusPublished - Oct 2019

Fingerprint

Parkinson Disease
Quality of Life
Meta-Analysis
Gait
Randomized Controlled Trials
Outcome Assessment (Health Care)
Exercise
Walking Speed

Cite this

@article{a8eaa7c1d6e543bdb727b7734d1d03ae,
title = "Home-based prescribed exercise improves balance-related activities in people with Parkinson’s disease and has benefits similar to centre-based exercise: A systematic review",
abstract = "Questions: In people with Parkinson's disease, does home-based prescribed exercise improve balance-related activities and quality of life compared with no intervention? Are the effects of home-based exercise similar to those of equivalent centre-based exercise? Design: Systematic review and meta-analysis of randomised and quasi-randomised controlled trials. Participants: Adults diagnosed with idiopathic Parkinson's disease. Intervention: Predominantly home-based prescribed exercise (defined as a minimum of two-thirds of the exercise being completed at home). The intervention had to primarily involve physical practice of exercises targeting gait and/or standing balance compared with either control (ie, usual care only, a sham intervention or no physiotherapy) or equivalent predominantly centre-based exercise. Outcome measures: The primary outcome was balance-related activities and the secondary outcomes were gait speed, Berg Balance Scale, Functional Reach test, and quality of life. Results: Sixteen trials met the inclusion criteria and all contributed to the meta-analyses. Twelve trials compared home-based prescribed exercise with control, and four trials compared home-based prescribed exercise with equivalent centre-based exercise. Home-based prescribed exercise improved balance-related activities (SMD 0.21, 95{\%} CI 0.10 to 0.32) and gait speed (SMD 0.30, 95{\%} CI 0.12 to 0.49), but not quality of life (SMD 0.11, 95{\%} CI −0.01 to 0.23) compared with control. Home-based and centre-based exercise had similar effects on balance-related activities (SMD −0.04, 95{\%} CI −0.36 to 0.27) and quality of life (SMD −0.08, 95{\%} CI −0.41 to 0.24). Conclusion: Home-based prescribed exercise improves balance-related activities and gait speed in people with Parkinson's disease, and these improvements are similar to improvements with equivalent centre-based exercise. ",
keywords = "Exercise, Home based, Parkinson disease, Rehabilitation, Systematic review",
author = "Allyson Flynn and Natalie Allen and Sarah Dennis and Colleen Canning and Elisabeth Preston",
year = "2019",
month = "10",
doi = "10.1016/j.jphys.2019.08.003",
language = "English",
volume = "65",
pages = "189--199",
journal = "Australian Journal of Physiotherapy",
issn = "0004-9514",
publisher = "Australian Physiotherapy Association",
number = "4",

}

Home-based prescribed exercise improves balance-related activities in people with Parkinson’s disease and has benefits similar to centre-based exercise : A systematic review. / Flynn, Allyson; Allen, Natalie; Dennis, Sarah; Canning, Colleen; Preston, Elisabeth.

In: Journal of Physiotherapy, Vol. 65, No. 4, 10.2019, p. 189-199.

Research output: Contribution to journalLiterature review

TY - JOUR

T1 - Home-based prescribed exercise improves balance-related activities in people with Parkinson’s disease and has benefits similar to centre-based exercise

T2 - A systematic review

AU - Flynn, Allyson

AU - Allen, Natalie

AU - Dennis, Sarah

AU - Canning, Colleen

AU - Preston, Elisabeth

PY - 2019/10

Y1 - 2019/10

N2 - Questions: In people with Parkinson's disease, does home-based prescribed exercise improve balance-related activities and quality of life compared with no intervention? Are the effects of home-based exercise similar to those of equivalent centre-based exercise? Design: Systematic review and meta-analysis of randomised and quasi-randomised controlled trials. Participants: Adults diagnosed with idiopathic Parkinson's disease. Intervention: Predominantly home-based prescribed exercise (defined as a minimum of two-thirds of the exercise being completed at home). The intervention had to primarily involve physical practice of exercises targeting gait and/or standing balance compared with either control (ie, usual care only, a sham intervention or no physiotherapy) or equivalent predominantly centre-based exercise. Outcome measures: The primary outcome was balance-related activities and the secondary outcomes were gait speed, Berg Balance Scale, Functional Reach test, and quality of life. Results: Sixteen trials met the inclusion criteria and all contributed to the meta-analyses. Twelve trials compared home-based prescribed exercise with control, and four trials compared home-based prescribed exercise with equivalent centre-based exercise. Home-based prescribed exercise improved balance-related activities (SMD 0.21, 95% CI 0.10 to 0.32) and gait speed (SMD 0.30, 95% CI 0.12 to 0.49), but not quality of life (SMD 0.11, 95% CI −0.01 to 0.23) compared with control. Home-based and centre-based exercise had similar effects on balance-related activities (SMD −0.04, 95% CI −0.36 to 0.27) and quality of life (SMD −0.08, 95% CI −0.41 to 0.24). Conclusion: Home-based prescribed exercise improves balance-related activities and gait speed in people with Parkinson's disease, and these improvements are similar to improvements with equivalent centre-based exercise. 

AB - Questions: In people with Parkinson's disease, does home-based prescribed exercise improve balance-related activities and quality of life compared with no intervention? Are the effects of home-based exercise similar to those of equivalent centre-based exercise? Design: Systematic review and meta-analysis of randomised and quasi-randomised controlled trials. Participants: Adults diagnosed with idiopathic Parkinson's disease. Intervention: Predominantly home-based prescribed exercise (defined as a minimum of two-thirds of the exercise being completed at home). The intervention had to primarily involve physical practice of exercises targeting gait and/or standing balance compared with either control (ie, usual care only, a sham intervention or no physiotherapy) or equivalent predominantly centre-based exercise. Outcome measures: The primary outcome was balance-related activities and the secondary outcomes were gait speed, Berg Balance Scale, Functional Reach test, and quality of life. Results: Sixteen trials met the inclusion criteria and all contributed to the meta-analyses. Twelve trials compared home-based prescribed exercise with control, and four trials compared home-based prescribed exercise with equivalent centre-based exercise. Home-based prescribed exercise improved balance-related activities (SMD 0.21, 95% CI 0.10 to 0.32) and gait speed (SMD 0.30, 95% CI 0.12 to 0.49), but not quality of life (SMD 0.11, 95% CI −0.01 to 0.23) compared with control. Home-based and centre-based exercise had similar effects on balance-related activities (SMD −0.04, 95% CI −0.36 to 0.27) and quality of life (SMD −0.08, 95% CI −0.41 to 0.24). Conclusion: Home-based prescribed exercise improves balance-related activities and gait speed in people with Parkinson's disease, and these improvements are similar to improvements with equivalent centre-based exercise. 

KW - Exercise

KW - Home based

KW - Parkinson disease

KW - Rehabilitation

KW - Systematic review

UR - http://www.scopus.com/inward/record.url?scp=85072055089&partnerID=8YFLogxK

U2 - 10.1016/j.jphys.2019.08.003

DO - 10.1016/j.jphys.2019.08.003

M3 - Literature review

VL - 65

SP - 189

EP - 199

JO - Australian Journal of Physiotherapy

JF - Australian Journal of Physiotherapy

SN - 0004-9514

IS - 4

ER -