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
UR - http://www.mendeley.com/research/homebased-prescribed-exercise-improves-balancerelated-activities-people-parkinsons-disease-benefits
U2 - 10.1016/j.jphys.2019.08.003
DO - 10.1016/j.jphys.2019.08.003
M3 - Article
C2 - 31521554
AN - SCOPUS:85072055089
SN - 1836-9553
VL - 65
SP - 189
EP - 199
JO - Journal of Physiotherapy
JF - Journal of Physiotherapy
IS - 4
ER -