The Effects of the Hopeful Outdoor Parkinson Exercise (HOPE) Program on Improving Balance Performance in Parkinsonian Non-fallers and Single Fallers

The Hong Kong Polytechnic University

Status: Completed

Conditions: Parkinson's Disease

Treatments: Behavioral: an 8-week upper limb and hand exercise program; Behavioral: an 8-week blended indoor-outdoor exercise program

Study type: Interventional

Funder types: Other

Identifiers

NCT01799681

approvalletter_20110823001

Details and patient eligibility

About

To determine whether the 8-week Hopeful Outdoor Parkinson's Exercise (HOPE) Program would be effective in improving balance performance, physical functions, gait parameter, balance confidence, health-related quality-of-life, disease-specific motor performance and fall-related outcomes in Parkinson's disease (PD) non-fallers and single fallers.

Full description

Previous studies demonstrated that multi-modal balance training program was effective in improving balance performance in people with PD. However they did not include all the balance domains and outdoor fall-prone activities have been overlooked. We designed a task- and context-specific balance training program based on the framework of the Balance Evaluation Systems Test (BESTest) to target all six balance domains including biomechanical constraints, stability limits and verticality, anticipatory postural adjustments, reactive postural responses, sensori-motor integration and dynamic gait control.

Enrollment: 84 patients

Sex: All

Ages: 30 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• diagnosed with PD by a neurologist (Fahn and Elton, 1987);
• aged 30 to 85 years;
• at modified Hoehn and Yahr (H&Y) stage 1.5 to 3 (Hoehn and Yahr ,1967; Goetz et al., 2004);
• able and willing to give written consent for participation in the study;
• living at home in the community;
• able to walk independently for 30 metres with or without an assistive device.

Exclusion criteria

• any neurological conditions other than PD;
• significant musculoskeletal or cardiopulmonary diseases;
• other disorders that may affect balance or locomotion;
• taken any structured behavioral or exercise programs in the past 3 months
• or they are receiving regular physical rehabilitation at present;
• unstable condition on anti-parkinsonian medications;
• surgical interventions for PD;
• communication or cognitive deficits with mini-mental state examination, (MMSE) <24/30 (Folstein et al., 1975);
• a history of more than two falls in the previous 12 months.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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84 participants in 2 patient groups

EXPERIMENTAL

Experimental group

Description:

a 4-week indoor and 4-week outdoor balance training with stretching, strength and functional training, Balance Dance, Modified Wing Chun, Square stepping exercise, and fall-prone activities practice

Treatment:

Behavioral: an 8-week blended indoor-outdoor exercise program

CONTROL

Active Comparator group

Description:

an eight-week training on upper limb stretching and strengthening, hand agility exercise, knot tying and Chinese calligraphy

Treatment:

Behavioral: an 8-week upper limb and hand exercise program