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Meta-Analysis
. 2019 Oct;65(4):189-199.
doi: 10.1016/j.jphys.2019.08.003. Epub 2019 Sep 11.

Home-based prescribed exercise improves balance-related activities in people with Parkinson's disease and has benefits similar to centre-based exercise: a systematic review

Allyson Flynn  1 , Natalie E Allen  2 , Sarah Dennis  3 , Colleen G Canning  2 , Elisabeth Preston  4
Affiliations
Free article
Meta-Analysis

Home-based prescribed exercise improves balance-related activities in people with Parkinson's disease and has benefits similar to centre-based exercise: a systematic review

Allyson Flynn et al. J Physiother. 2019 Oct.
Free article

Abstract

Questions: In people with Parkinson's disease, does home-based prescribed exercise improve balance-related activities and quality of life compared with no intervention? Are the effects of home-based exercise similar to those of equivalent centre-based exercise?

Design: Systematic review and meta-analysis of randomised and quasi-randomised controlled trials.

Participants: Adults diagnosed with idiopathic Parkinson's disease.

Intervention: Predominantly home-based prescribed exercise (defined as a minimum of two-thirds of the exercise being completed at home). The intervention had to primarily involve physical practice of exercises targeting gait and/or standing balance compared with either control (ie, usual care only, a sham intervention or no physiotherapy) or equivalent predominantly centre-based exercise.

Outcome measures: The primary outcome was balance-related activities and the secondary outcomes were gait speed, Berg Balance Scale, Functional Reach test, and quality of life.

Results: Sixteen trials met the inclusion criteria and all contributed to the meta-analyses. Twelve trials compared home-based prescribed exercise with control, and four trials compared home-based prescribed exercise with equivalent centre-based exercise. 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) compared with control. 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).

Conclusion: Home-based prescribed exercise improves balance-related activities and gait speed in people with Parkinson's disease, and these improvements are similar to improvements with equivalent centre-based exercise.

Registration: PROSPERO CRD 42018107331.

Keywords: Exercise; Home based; Parkinson disease; Rehabilitation; Systematic review.

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