Article

OBJECTIVES: To investigate the short- and long-term effects of a task- and
context-specific balance training program on dynamic balance and functional
performance, and to explore the effects on preventing total and injurious falls
in parkinsonian nonfallers. DESIGN: A randomized controlled trial with group
allocation single-blinded to the assessor. SETTING:
Community centers, malls, and
outdoor parks. PARTICIPANTS: Nonfallers with Parkinson disease (PD) (N=70; mean
age +/- SD, 61.2+/-8.8y) randomly assigned to either a balance (BAL) group (n=32)
or a control (CON) group (n=38). INTERVENTIONS: The BAL group received 4 weeks of
indoor and 4 weeks of outdoor balance training (with a 2-h session per week). The
CON group received 8 weeks of upper limb training at the same dosage. Both groups
were instructed to perform 3 hours of home exercise weekly posttraining. MAIN
OUTCOME MEASURES: (1) Dynamic balance performance: Mini-Balance Evaluation
Systems Test (Mini-BESTest); (2) Functional performance: functional reach (FR), 5
times sit-to-stand (FTSTS), 1-leg-stance (OLS), Timed Up and Go (TUG), and
dual-task TUG tests; (3) Fall-related outcomes: ratios of total nonfallers to
fallers and noninjurious fallers to injurious fallers, total and injurious fall
rates, times to first falls and injurious falls. RESULTS: Sixty-eight
participants completed training. A total of 7 patients (10%) withdrew before the
6-month follow-up, but not because of any adverse effects. At immediate and 6
months posttraining, the BAL group showed significantly greater improvements
(from baseline) than the CON group in Mini-BESTest total scores, FR distances,
and OLS times, together with greater time reductions in FTSTS, TUG, and dual-task
TUG tests (all P<.05). The number of injurious fallers was significantly lower in
the BAL group at 6-month follow-up. CONCLUSIONS: This task- and context-specific
balance training program improved the dynamic balance and fall-prone functional
performance of PD nonfallers for up to 6 months after training. The BAL group
showed a reduction in injurious fallers.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS