Recently, a group of Australian academic physiotherapists scoured the existing literature to identify all the available high-quality evidence about the effects of home-based exercise in Parkinson's disease. In particular, they sought trials comparing home exercise to no exercise, and trials comparing home exercise to centre-based exercise.
Twelve trials compared home-based prescribed exercise with control. 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).
The above results are reported as standardised mean differences. For readers who are unfamililar with interpreting these statistics, the authors of the review also converted these into equivalent results with units that might be more familiar and interpretable. For example, the effect on gait speed equates to an improvement of 0.12 m/s.
Four trials compared home-based prescribed exercise with equivalent centre-based exercise. 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).
Overall, the authors concluded that home-based prescribed exercise improves balance and gait speed in people with Parkinson’s disease. Home-based and centre-based exercise were found to have similar effects on balance-related activities and quality of life. This suggests that home-based prescribed exercise may be an effective strategy for delivering high-quality exercise to people with Parkinson’s disease in health services where resources are limited.
> From: Flynn et al., J Physiother 65 (2019) (Epub ahead of print). All rights reserved to Australian Physiotherapy Association. Click here for the online summary.
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