This study aimed to explore the feasibility and potential effectiveness of a multidomain fall prevention intervention specifically designed for people with Parkinson’s disease, including those with cognitive impairment, who frequently experience falls.
The home-based intervention was delivered over six months by occupational therapists and physiotherapists. The personalized intervention included home fall-hazard reduction (e.g., sensor lights, bathroom rails), exercise (to improve lower limb muscle strength and balance and reduce freezing of gait), and safer mobility behavior training (e.g., pausing to get balance between standing up and walking). Participants received 8 to 12 home visits and completed the rest of the intervention independently, supported by care-partners when necessary.
Twenty-nine participants (49% recruitment rate, 10% drop-out rate) with moderate to advanced Parkinson’s disease, a history of recurrent falls, and mild to moderate cognitive impairment took part in the study. Adherence to the intervention was moderate to high (75–100%), with no adverse events reported. Twenty-one participants (81%) met or exceeded their safer mobility goals on the Goal Attainment Scale. Overall, participants showed an improvement of 1.1 points on the Short Physical Performance Battery (p0.01). Although exploratory results indicated a nearly 50% reduction in fall rates during the six-month follow-up period, this reduction was not statistically significant (IRR 0.54, 95% CI 0.30–1.00, p=0.05).
The multidomain occupational therapy and physiotherapy intervention for people with Parkinson’s disease with recurrent falls was feasible and appeared to enhance mobility safety. A randomized trial with sufficient power to detect effects on falls is warranted.
This study suggests that a comprehensive, home-based multidomain intervention can be effectively implemented for people with Parkinson’s disease and recurrent falls, potentially leading to improved mobility and reduced fall risk. Future research should focus on larger, randomized control trials to confirm these findings and further explore the benefits of multidomain interventions in this population.
rehabilitation
accidental falls
