Effects of Group, Individual, and Home Exercise in Persons With Parkinson Disease: A Randomized Clinical Trial Balance training in individuals with Parkinson's disease: Therapist-supervised vs. home-based exercise programme. Exercise programs improve mobility and balance in people with Parkinson's disease. Exercise for People in Early- or Mid-Stage Parkinson Disease: A 16-Month Randomized Controlled Trial Home-based virtual reality balance training and conventional balance training in Parkinson's disease: A randomized controlled trial. A randomised controlled trial of a home based exercise programme to reduce the risk of falling among people with Parkinson’s disease The Effects of Highly Challenging Balance Training in Elderly With Parkinson’s Disease The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson's disease. Community-based group exercise for persons with Parkinson disease: a randomized controlled trial. Home-based step training using videogame technology in people with Parkinson’s disease: a single-blinded randomised controlled trial Effects of Dance on Gait and Balance in Parkinson’s Disease: A Comparison of Partnered and Nonpartnered Dance Movement Is Irish set dancing feasible for people with Parkinson's disease in Ireland? A novel conceptual framework for balance training in Parkinson’s disease-study protocol for a randomised controlled trial A randomized controlled trial of movement strategies compared with exercise for people with Parkinson's disease. Effects of home-based exercise on postural control and sensory organization in individuals with Parkinson disease. Comparison of the effects of a physiotherapist-supervised exercise programme and a self-supervised exercise programme on quality of life in patients with Parkinson’s disease Whole body vibration versus conventional physiotherapy to improve balance and gait in Parkinson's disease.
Background and Purpose : Comparative studies of exercise interventions for people with Parkinson disease ( PD ) rarely considered how one should deliver the intervention . The objective of this study was to compare the success of exercise when administered by ( 1 ) home exercise program , ( 2 ) individualized physical therapy , or ( 3 ) a group class . We examined if common comorbidities associated with PD impacted success of each intervention . Methods : Fifty-eight people ( age = 63.9 ± 8 years ) with PD participated . People were r and omized into ( 1 ) home exercise program , ( 2 ) individual physical therapy , or ( 3 ) group class intervention . All arms were st and ardized and based on the Agility Boot Camp exercise program for PD , 3 times per week for 4 weeks . The primary outcome measure was the 7-item Physical Performance Test . Other measures of balance , gait , mobility , quality of life , balance confidence , depressions , apathy , self-efficacy and UPDRS-Motor , and activity of daily living scores were included . Results : Only the individual group significantly improved in the Physical Performance Test . The individual exercise showed the most improvements in functional and balance measures , whereas the group class showed the most improvements in gait . The home exercise program improved the least across all outcomes . Several factors effected success , particularly for the home group . Discussion and Conclusions : An unsupervised , home exercise program is the least effective way to deliver exercise to people with PD , and individual and group exercises have differing benefits . Furthermore , people with PD who also have other comorbidities did better in a program directly supervised by a physical therapist . Video Abstract available for additional insights from the authors ( see Video , Supplemental Digital Content 1 , http://links.lww.com/JNPT/A112 ) BACKGROUND Poor locomotion and balance in Parkinson 's disease ( PD ) often diminishes independence . Accordingly , gait is considered one of the most relevant rehabilitation outcomes , and home-based balance exercises might be a viable mode of exercise delivery for individuals with PD . However , research on PD interventions rarely indicate best practice s to deliver exercises . Therefore , this study endeavoured to compare the efficacy of a home-based and therapist-supervised balance programme on gait parameters , dynamic balance , balance confidence and motivation in individuals diagnosed with PD . METHODS An experimental study design , including a cluster r and omized convenience sample , of 40 participants with idiopathic PD ( Hoehn and Yahr stage I-III ; age : 65.0±7.7years ) . Participants were divided into a therapist-supervised ( n=24 ) and home-based group ( n=16 ) . Groups received either eight weeks of balance training with an exercise therapist or a DVD . Outcome measures include the instrumented Timed-Up- and -Go , Functional Gait Analysis ( FGA ) , Activity-specific Balance confidence ( ABC ) scale and Intrinsic Motivation Inventory ( IMI ) . RESULTS Both groups improved in stride length ( p<0.05 ) . Similar FGA improved by 9 % and 16 % in the therapist-supervised and home-based group , respectively ( p<0.01 ) . Only the therapist-supervised group showed improvements in ABC ( p=0.051 ) , stride velocity ( p=0.0006 ) and cadence ( p=0.046 ) over the intervention ; the latter two were also better compared to home-based ( p<0.05 ) . Furthermore the therapist-supervised group were more motivated ( p=002 ) . CONCLUSION The home-based balance programme was effective in improving some aspects of gait , albeit the programme supervised by an exercise therapist included somewhat more benefits after the intervention i.e. stride velocity and cadence in individuals with mild to moderate PD Compromised balance and loss of mobility are among the major consequences of Parkinson 's disease ( PD ) . The literature documents numerous effective interventions for improving balance and mobility . The purpose of this study was to verify the effectiveness of two exercise programs on balance and mobility in people with idiopathic PD . Thirty-four participants , with idiopathic PD that ranged from Stage I to Stage III on the Hoehn & Yahr ( H&Y ) scale , were assigned to two groups . Group 1 ( n = 21 ; 67+/-9 years old ) was engaged in an intensive exercise program ( aerobic capacity , flexibility , strength , motor coordination and balance ) for 6 months : 72 sessions , 3 times a week , 60 minutes per session ; while Group 2 ( n = 13 ; 69+/-8 years old ) participated in an adaptive program ( flexibility , strength , motor coordination and balance ) for 6 months : 24 sessions , once a week , 60 minutes per session . Balance and basic functional mobility were assessed in pre- and post-tests by means of the Berg Balance Scale and the Timed Up and Go Test . Before and after the interventions , groups were similar in clinical conditions ( H&Y , UPDRS , and Mini-Mental ) . A MANOVA 2 ( programs ) by 2 ( moments ) revealed that both groups were affected by the exercise intervention . Univariate analyses showed that participants improved their mobility and balance from pre- to post-test . There were no differences between groups in either mobility or balance results . Both the intensive and adaptive exercise programs improved balance and mobility in patients with PD Background Exercise confers short-term benefits for individuals with Parkinson disease ( PD ) . Objective The purpose of the study was to compare short- and long-term responses among 2 supervised exercise programs and a home-based control exercise program . Design The 16-month r and omized controlled exercise intervention investigated 3 exercise approaches : flexibility/balance/function exercise ( FBF ) , supervised aerobic exercise ( AE ) , and home-based exercise ( control ) . Setting This study was conducted in outpatient clinics . Patients The participants were 121 individuals with PD ( Hoehn & Yahr stages 1–3 ) . Interventions The FBF program ( individualized spinal and extremity flexibility exercises followed by group balance/functional training ) was supervised by a physical therapist . The AE program ( using a treadmill , bike , or elliptical trainer ) was supervised by an exercise trainer . Supervision was provided 3 days per week for 4 months , and then monthly ( 16 months total ) . The control group participants exercised at home using the National Parkinson Foundation Fitness Counts program , with 1 supervised , clinic-based group session per month . Measurements Outcomes , obtained by blinded assessors , were determined at 4 , 10 , and 16 months . The primary outcome measures were overall physical function ( Continuous Scale — Physical Functional Performance [ CS-PFP ] ) , balance ( Functional Reach Test [ FRT ] ) , and walking economy ( oxygen uptake [ mL/kg/min ] ) . Secondary outcome measures were symptom severity ( Unified Parkinson 's Disease Rating Scale [ UPDRS ] activities of daily living [ ADL ] and motor subscales ) and quality of life ( 39-item Parkinson 's Disease Quality of Life Scale [ PDQ-39 ] ) . Results Of the 121 participants , 86.8 % , 82.6 % , and 79.3 % completed 4 , 10 , and 16 months , respectively , of the intervention . At 4 months , improvement in CS-PFP scores was greater in the FBF group than in the control group ( mean difference=4.3 , 95 % confidence interval [CI]=1.2 to 7.3 ) and the AE group ( mean difference=3.1 , 95 % CI=0.0 to 6.2 ) . Balance was not different among groups at any time point . Walking economy improved in the AE group compared with the FBF group at 4 months ( mean difference=−1.2 , 95 % CI=−1.9 to −0.5 ) , 10 months ( mean difference=−1.2 , 95 % CI=−1.9 to −0.5 ) , and 16 months ( mean difference=−1.7 , 95 % CI=−2.5 to −1.0 ) . The only secondary outcome that showed significant differences was UPDRS ADL subscale scores : the FBF group performed better than the control group at 4 months ( mean difference=−1.47 , 95 % CI=−2.79 to −0.15 ) and 16 months ( mean difference=−1.95 , 95 % CI=−3.84 to −0.08 ) . Limitations Absence of a non-exercise control group was a limitation of the study . Conclusions Findings demonstrated overall functional benefits at 4 months in the FBF group and improved walking economy ( up to 16 months ) in the AE group BACKGROUND / PURPOSE Virtual reality has the advantage to provide rich sensory feedbacks for training balance function . This study tested if the home-based virtual reality balance training is more effective than the conventional home balance training in improving balance , walking , and quality of life in patients with Parkinson 's disease ( PD ) . METHODS Twenty-three patients with idiopathic PD were recruited and underwent twelve 50-minute training sessions during the 6-week training period . The experimental group ( n = 11 ) was trained with a custom-made virtual reality balance training system , and the control group ( n = 12 ) was trained by a licensed physical therapist . Outcomes were measured at Week 0 ( pretest ) , Week 6 ( posttest ) , and Week 8 ( follow-up ) . The primary outcome was the Berg Balance Scale . The secondary outcomes included the Dynamic Gait Index , timed Up- and -Go test , Parkinson 's Disease Question naire , and the motor score of the Unified Parkinson 's Disease Rating Scale . RESULTS The experimental and control groups were comparable at pretest . After training , both groups performed better in the Berg Balance Scale , Dynamic Gait Index , timed Up- and -Go test , and Parkinson 's Disease Question naire at posttest and follow-up than at pretest . However , no significant differences were found between these two groups at posttest and follow-up . CONCLUSION This study did not find any difference between the effects of the home-based virtual reality balance training and conventional home balance training . The two training options were equally effective in improving balance , walking , and quality of life among community-dwelling patients with PD Objective : To evaluate the effectiveness of a personalised home programme of exercises and strategies for repeat fallers with Parkinson ’s disease ( PD ) . Method : Patients with a confirmed diagnosis of idiopathic PD , independently mobile , living at home in the community , experiencing more than one fall in the previous 12 months and with intact gross cognitive function were invited to participate in this r and omised controlled trial . Usual care was compared with a personalised 6 week , home based exercise and strategy programme . The primary outcomes were rates of falling at 8 weeks and 6 months . Whether participants had repeat fallen , nearly fallen or experienced injurious falls were also examined . Functional Reach , the Berg Balance Test , PD Self- assessment Scale and the Euro Quol were rated by a blinded assessor . Results : Participants were r and omised to the exercise ( n = 70 ) and control ( n = 72 ) groups . There was a consistent trend towards lower fall rates in the exercise group at both 8 weeks and 6 months and lower rates of injurious falls needing medical attention at 6 months . Lower rates of repeat near falling were evident for the exercise group at 8 weeks ( p = 0.004 ) and 6 months ( p = 0.007 ) . There was a positive effect of exercises at 6 months on Functional Reach ( p = 0.009 ) and quality of life ( p = 0.033 ) . No significant differences were found on other secondary outcomes measures . Conclusion : There was a trend towards a reduction in fall events and injurious falls with a positive effect of exercises on near falls and quality of life Background . Highly challenging exercises have been suggested to induce neuroplasticity in individuals with Parkinson ’s disease ( PD ) ; however , its effect on clinical outcomes remains largely unknown . Objective . To evaluate the short-term effects of the HiBalance program , a highly challenging balance-training regimen that incorporates both dual-tasking and PD-specific balance components , compared with usual care in elderly with mild to moderate PD . Methods . Participants with PD ( n = 100 ) were r and omized , either to the 10-week  HiBalance program  ( n = 51 ) or to the  control group ( n = 49 ) . Participants were evaluated before and after the intervention . The main outcomes were balance performance ( Mini-BESTest ) , gait velocity ( during normal and dual-task gait ) , and concerns about falling ( Falls Efficacy Scale – International ) . Performance of a cognitive task while walking , physical activity level ( average steps per day ) , and activities of daily living were secondary outcomes . Results . A total of 91 participants completed the study . After the intervention , the between group comparison showed significantly improved balance and gait performance in the training group . Moreover , although no significant between group difference was observed regarding gait performance during dual-tasking ; the participants in the training group improved their performance of the cognitive task while walking , as compared with the control group . Regarding physical activity levels and activities of daily living , in comparison to the control group , favorable results were found for the training group . No group differences were found for concerns about falling . Conclusions . The HiBalance program significantly benefited balance and gait abilities when compared with usual care and showed promising transfer effects to everyday living . Long-term follow-up assessment s will further explore these effects OBJECTIVE To assess immediate and near-term effects of 2 exercise training programs for persons with idiopathic Parkinson 's disease ( IPD ) . DESIGN R and omized control trial . SETTING Public health facility and medical center . PARTICIPANTS Fifteen persons with IPD . INTERVENTION Combined group ( balance and resistance training ) and balance group ( balance training only ) underwent 10 weeks of high-intensity resistance training ( knee extensors and flexors , ankle plantarflexion ) and /or balance training under altered visual and somatosensory sensory conditions , 3 times a week on nonconsecutive days . Groups were assessed before , immediately after training , and 4 weeks later . MAIN OUTCOME MEASURES Balance was assessed by computerized dynamic posturography  , which determined the subject 's response to reduced or altered visual and somatosensory orientation cues ( Sensory Orientation Test [ SOT ] ) . Muscle strength was assessed by measuring the amount of weight a participant could lift , by using a st and ardized weight- and -pulley system , during a 4-repetition-maximum test of knee extension , knee flexion , and ankle plantarflexion . RESULTS Both types of training improved SOT performance . This effect was larger in the combined group . Both groups could balance longer before falling , and this effect persisted for at least 4 weeks . Muscle strength increased marginally in the balance group and substantially in the combined group , and this effect persisted for at least 4 weeks . CONCLUSION Muscle strength and balance can be improved in persons with IPD by high-intensity resistance training and balance training The purpose of this study was to compare group boxing training to traditional group exercise on function and quality of life in persons with Parkinson disease ( PD ) . A convenience sample of adults with PD ( n = 31 ) were r and omly assigned to boxing training or traditional exercise for 24 - 36 sessions , each lasting 90 minutes , over 12 weeks . Boxing training included : stretching , boxing ( e.g. lateral foot work , punching bags ) , resistance exercises , and aerobic training . Traditional exercise included : stretching , resistance exercises , aerobic training , and balance activities . Participants were tested before and after completion of training on balance , balance confidence , mobility , gait velocity , gait endurance , and quality of life . The traditional exercise group demonstrated significantly greater gains in balance confidence than the boxing group ( p < 0.025 ) . Only the boxing group demonstrated significant improvements in gait velocity and endurance over time with a medium between-group effect size for the gait endurance ( d = 0.65 ) . Both groups demonstrated significant improvements with the balance , mobility , and quality of life with large within-group effect sizes ( d ≥ 0.80 ) . While groups significantly differed in balance confidence after training , both groups demonstrated improvements in most outcome measures . Supporting options for long-term community-based group exercise for persons with PD will be an important future consideration for rehabilitation professionals Objectives : To determine whether 12-week home-based exergame step training can improve stepping performance , gait and complementary physical and neuropsychological measures associated with falls in Parkinson ’s disease . Design : A single-blinded r and omised controlled trial . Setting : Community ( experimental intervention ) , university laboratory ( outcome measures ) . Subjects : Sixty community-dwelling people with Parkinson ’s disease . Interventions : Home-based step training using videogame technology . Main measures : The primary outcomes were the choice stepping reaction time test and Functional Gait Assessment . Secondary outcomes included physical and neuropsychological measures associated with falls in Parkinson ’s disease , number of falls over six months and self-reported mobility and balance . Results : Post intervention , there were no differences between the intervention ( n = 28 ) and control ( n = 25 ) groups in the primary or secondary outcomes except for the Timed Up and Go test , where there was a significant difference in favour of the control group ( P = 0.02 ) . Intervention participants reported mobility improvement , whereas control participants reported mobility deterioration — between-group difference on an 11-point scale = 0.9 ( 95 % confidence interval : −1.8 to −0.1 , P = 0.03 ) . Interaction effects between intervention and disease severity on physical function measures were observed ( P = 0.01 to P = 0.08 ) with seemingly positive effects for the low-severity group and potentially negative effects for the high-severity group . Conclusion : Overall , home-based exergame step training was not effective in improving the outcomes assessed . However , the improved physical function in the lower disease severity intervention participants as well as the self-reported improved mobility in the intervention group suggest home-based exergame step training may have benefits for some people with Parkinson ’s disease Partnered tango dance can improve balance and gait in individuals with Parkinson ’s disease ( PD ) .  Partnered dance may allow these individuals to challenge balance more than nonpartnered dance . Alternatively , partnered practice could reduce balance gains because the participant may rely on the partner as a balance aid when challenged . The authors compared the effects of partnered and nonpartnered dance on balance and mobility in 39 people ( 11 women ) with mild-moderate PD ( Hoehn and Yahr stages I-III ) . Participants were r and omly assigned to  partnered or nonpartnered tango and attended 1-hour classes twice per week , completing 20 lessons within 10 weeks . Balance and gait were evaluated in the weeks immediately before , immediately after , and 1 month after the intervention . Both groups significantly improved on the Berg Balance Scale , comfortable and fast-as-possible walking velocity , and cadence . Improvements were maintained at the 1-month follow-up . The nonpartnered class improved as much as the partnered class ; however , partnered participants expressed more enjoyment and interest in continuing OBJECTIVE To investigate if community-based Irish set dancing is feasible in Irish adults with Parkinson 's disease . METHODS Over an eight week period , ten participants attended one set dancing class per week and completed a home programme in parallel . Feasibility was assessed by monitoring adverse effects , participants ' verbal feedback , compliance rates and feedback from an exit question naire . Participants were assessed using the Berg balance scale , 6-min walk test , UPDRS-3 and PDQ-39 , before and after the intervention . RESULTS No adverse effects were detected . Attendance at classes was 86 % . Compliance with the home programme was 67 % . Findings from the exit question naire showed participants enjoyed participating and reported improvements in aspects of health including balance . Quality of life improved with the dance programme and there was a trend toward improvement on the UPDRS-3 . CONCLUSION These findings suggest community-based Irish set dancing is a feasible form of exercise that can positively influence quality of life Background There is increasing scientific knowledge about the interaction between physiological ( musculoskeletal , neuromuscular , cognitive and sensory ) systems and their influence on balance and walking impairments in Parkinson ’s disease . We have developed a new conceptual framework for balance training , emphasising specific components of balance control related to Parkinson ’s disease symptoms by using highly challenging , progressive and varying training conditions . The primary aim of this proposed r and omised controlled trial will be to investigate the short-term and long-term effects of a 10-week balance training regime in elderly with Parkinson ’s disease . Methods / Design Eighty participants with mild to moderate idiopathic Parkinson ’s disease will be recruited and r and omly allocated to an intervention group receiving balance training or a control group whose participants will continue to receive their usual care . The intervention will consist of a 10-week group training regime ( 1-hour training , three times per week ) , which will be led by two physiotherapists to ensure training progression and safety . The conceptual framework will be applied by addressing specific balance components ( sensory integration , anticipatory postural adjustments , motor agility , stability limits ) through varying training conditions and structured progression . Assessment will be conducted through a multi-dimensional battery of outcomes , prior to and immediately after the 10-week intervention , and at 9 and 15 months ’ follow-up after entering the study . Primary outcome measures will be balance performance ( assessed using the Mini Balance Evaluation Systems Test ) , change in gait velocity ( m/s ) between single and dual task walking , and fear of falling ( evaluated using the Fall Efficacy Scale International ) . Discussion This study has the potential to provide new insight and knowledge of the effects of specific , varied and challenging balance training on a wide health spectrum in elderly with PD . If found to be effective , this pragmatic approach with translation of theory into practice , can be implemented in existing outpatient care . Trial registration This r and omized controlled clinical trial was conducted to compare the effects of movement rehabilitation strategies and exercise therapy in hospitalized patients with idiopathic Parkinson 's disease . Participants were r and omly assigned to a group that received movement strategy training or musculoskeletal exercises during 2 consecutive weeks of hospitalization . The primary outcome was disability as measured by the Unified Parkinson 's Disease Rating Scale , UPDRS ( motor and ADL components ) . Secondary outcomes were balance , walking speed , endurance , and quality of life . Assessment s were carried out by blinded testers at baseline , after the 2 weeks of treatment and 3 months after discharge . The movement strategy group showed improvements on several outcome measures from admission to discharge , including the UPDRS , 10 m walk , 2 minute walk , balance , and PDQ39 . However , from discharge to follow up there was significant regression in performance on the 2 minute walk and PDQ39 . For the exercise group , quality of life improved significantly during inpatient hospitalization and this was retained at follow-up . Inpatient rehabilitation produces short term reductions in disability and improvements in quality of life in people with Parkinson 's disease Loss of function and postural instability occur in Parkinson disease ( PD ) .  Dynamic exercise interventions are successful in improving motor control and physical function . However , most programs are based in a health facility or physical therapy setting and involve travel . With the limitations associated with PD ( e.g. health care and medication cost as well as travel limitations ) these therapies may be inaccessible and exclude some individuals from maintaining or increasing their function . The purpose of this study was to evaluate the effectiveness of a home-based exercise intervention on postural control in individuals with PD . Multivariate analysis of covariance was performed on individuals with PD ( N = 10 ) and healthy aged-matched controls ( N = 10 ) . Participants were assessed utilizing  computerized dynamic posturography ( CDP )  before and after a 10-week exercise intervention . Participants were instructed on proper technique prior to the intervention , were given an illustrated home program , and were monitored weekly concerning their progress . Pre-intervention assessment demonstrated that individuals with PD had statically lower scores on a Sensory Organization Test ( p < .05 ) . Following the intervention , results indicated no statistical difference between individuals with PD and aged match controls ( p > .05 ) . This initial study indicates that a home exercise intervention is an effective method of improving postural control in individuals with PD . Results from this investigation support further study to determine the extent to which both preventative and restorative home-based programs can improve postural control Objectives : To compare the effects of a physiotherapist-supervised exercise programme in an exercise unit and self-supervised home exercise programme on quality of life in patients with Parkinson ’s disease . Design : Assessor-blinded , quasi-r and omized trial ( alternate allocation ) . Setting : An outpatient exercise unit ; home setting s. Participants : Thirty patients with idiopathic Parkinson ’s disease , Hoehn & Yahr I — III , stable medication use . Interventions : Patients were included in the physiotherapist-supervised or home group . The exercise programme was performed for 10 weeks , three times/week either under the supervision of a physiotherapist or at home without supervision . Main outcome measures : Parkinson ’s Disease Quality of Life Question naire ( PDQLQ ) , Nottingham Health Profile ( NHP ) , Unified Parkinson ’s Disease Rating Scale ( UPDRS ) , Beck Depression Inventory ( BDI ) . Results : Patients in the supervised physiotherapy group improved more than the home exercise group in Parkinson ’s Disease Quality of Life Question naire ( total score , Parkinson ’s symptoms , emotional function ) , Nottingham Health Profile total , Unified Parkinson ’s Disease Rating Scale ( all domains ) and Beck Depression Inventory scores . Conclusions : The exercise programme under physiotherapist supervision was found to be more effective at improving activities of daily living , motor , mental , emotional functions and general health quality in patients with Parkinson ’s disease compared with a self-supervised home programme OBJECTIVE To compare the effects of whole body vibration ( WBV ) and conventional physiotherapy ( PT ) on levodopa-resistant disturbances of balance and gait in idiopathic Parkinson 's disease ( PD ) . DESIGN R and omized controlled rater-blinded trial comparing 2 active interventions , final follow-up assessment 4 weeks after termination of active intervention . SETTING Specialized referral center , hospitalized care . PARTICIPANTS Patients with PD and dopa-resistant imbalance on stable dopamine replacement medication ( N=27 ) were r and omized ( intent-to-treat population ) to receive WBV  ( n=13 ) or  conventional PT ( controls , n=14 ) . Twenty-one patients ( per protocol population ) completed follow-up ( 14 men , 7 women ; mean age , 73.8 y ; age range , 62 - 84 y ; mean disease duration , 7.2 y ; mean dopa-equivalent dose , 768 mg/d ) . INTERVENTION Subjects were r and omized to receive 30 sessions ( two 15-min sessions a day , 5 days a week ) of either WBV on an oscillating platform or conventional balance training including exercises on a tilt board .  Twenty-one subjects ( 10 with WBV , 11 controls ) were available for follow-up 4 weeks after treatment termination . MAIN OUTCOME MEASURES The primary measure was Tinetti Balance Scale score . Secondary clinical ratings included st and -walk-sit test , walking velocity , Unified Parkinson 's Disease Rating Scale ( section III motor examination ) score , performance in the pull test , and dynamic posturography . RESULTS The Tinetti score improved from 9.3 to 12.8 points in the WBV group and from 8.3 to 11.7 in the controls . All secondary measures , except posturography , likewise improved at follow-up compared with baseline in both groups . Quantitative dynamic posturography only improved in patients with WBV ( 1937 - 1467 mm ) whereas there was no significant change in controls ( 1832 - 2030 mm ) . CONCLUSIONS Equilibrium and gait improved in patients with PD receiving conventional WBV or conventional PT in the setting of a comprehensive rehabilitation program . There was no conclusive evidence for superior efficacy of WBV compared with conventional balance training
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 .
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 ?