This study aimed to explore: 1) how a multidomain fall prevention program was perceived by people with Parkinson’s disease who fall recurrently and their care-partners, and 2) factors that influenced engagement with the program.
Twenty-nine recurrent fallers with moderately advanced Parkinson’s disease, including those with cognitive impairment, and their care-partners (when required) participated in a single group trial of a 6-month, home-based, multidomain fall prevention program. The program was delivered collaboratively by occupational therapists and physiotherapists and included home fall-hazard reduction (e.g., decluttering), exercise (e.g., balance, strength and reducing freezing of gait), and strategies to foster safer mobility (e.g., slowing down and concentrating). Semi-structured interviews were conducted at the end of the program. Interviews from 18 participants were purposively sampled, transcribed verbatim, and analyzed using inductive thematic analysis.
Five themes were identified: 1) one size does not fit all, 2) benefits of collaboration and shared decision-making between participants and therapists, 3) capacity building and increased awareness of safety, 4) impact of disease perception on program engagement and 5) the ease (or not) of making changes. Participants and their care-partners valued the tailored, home-based program that incorporated shared decision-making and was delivered by expert therapists. Participants reported developing a greater awareness of safety and adopting safer mobility strategies, which for some became habitual. Seeing improvements, being held accountable, and having ongoing support from therapists and care-partners were important for continued engagement with the program. However, fatalistic beliefs about disease progression and Parkinson’s impairments such as apathy and motor fluctuations were barriers to engagement for some participants.
People with Parkinson’s disease who fall recurrently, along with their care-partners, valued the home-based, personalized, multidomain program and were able to engage with support and guidance from therapists.
This study highlights the benefits of a tailored, home-based minimally supervised multidomain intervention for fall prevention in people with Parkinson’s disease. The findings suggest that such programs, when delivered collaboratively by occupational therapists and physiotherapists, can enhance safety awareness and promote safer mobility behaviors. Future research should focus on larger trials to confirm these findings and further investigate the benefits of tailored, multidomain interventions on falls in this population.
rehabilitation
accidental falls
