Objective: To determine the feasibility and acceptability of a fall prevention program for people with moderate to severe Parkinson’s disease (PD).

Background: Evidence shows exercise can reduce falls in people with milder PD, but there is no evidence for how to reduce falls in people with more severe PD. Most people with PD develop cognitive impairments, however cognitively impaired people have often been excluded from research into falls prevention. There is a need to develop and trial interventions specifically designed for people with moderate to severe PD, including those with cognitive impairment.

Method: Participants with PD and at least one fall in the prior year undertook a combined physiotherapy and occupational therapy intervention. Participants with cognitive impairment were included if their Montreal Cognitive Assessment (MoCA) was > 5 and they had a willing and able care-partner. The home-based intervention included exercise, environmental and behavioral modification, and took into account each individual’s functional cognition and safe mobility goals. Each participant received 8 to 10 home visits and exercised for 30 minutes up to 6 times per week over 4 months. Primary outcomes were the feasibility and acceptability of the intervention and semi-structured interviews were conducted in participants’ homes at the end of the intervention.

Results: Twenty-five people were screened to recruit seven participants (28%) [table 1]. All participants completed the study with no adverse events related to the intervention. Preliminary analysis [table 2] shows that there was good overall adherence to the program (> 70% of recommendations and exercise sessions completed). Participants reported that the intervention was beneficial and valued that it was home-based and delivered by therapists trained in PD. However, participants reported that it was difficult to consistently implement the behavioural recommendations.

Conclusion: A home-based, tailored and multifactorial intervention for falls prevention in people with moderate to advanced PD is feasible and acceptable. Further research is underway to improve and evaluate the program.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-tailored-and-multifactorial-fall-prevention-program-for-people-with-parkinsons-disease-a-feasibility-study/