Multimodal Training Reduces Fall Frequency as Physical Activity Increases in Individuals With Parkinson's Disease

J Phys Act Health. 2019 Dec 1;16(12):1085-1091. doi: 10.1123/jpah.2018-0595. Epub 2019 Oct 24.

Abstract

Background: Parkinson's disease (PD) results in a global decrease in information processing, ultimately resulting in dysfunction executing motor-cognitive tasks. Motor-cognitive impairments contribute to postural instability, often leading to falls and decreased physical activity. The aim of this study was to determine the effects of a multimodal training (MMT) versus single-modal (SMT) training on motor symptoms, fall frequency, and physical activity in patients with PD classified as fallers.

Methods: Individuals with PD were randomized into SMT (n = 11) or MMT (n = 10) and completed training 3 times per week for 8 weeks. The SMT completed gait and cognitive training separately, whereas MMT completed gait and cognitive training simultaneously during each 45-minute session. Physical activity, 30-day fall frequency, and PD motor symptoms were assessed at baseline, posttreatment, and during a 4-week follow-up.

Results: Both groups exhibited significant (P < .05) improvements in clinical ratings of motor function, as symptoms improved by 8% and 15% for SMT and MMT, respectively. Physical activity significantly increased (P < .05) for both groups from baseline (mean steps 4942 [4415]) to posttreatment (mean steps 5914 [5425]). The MMT resulted in a significant 60% reduction in falls.

Conclusions: Although SMT and MMT approaches are both effective in improving physical activity and motor symptoms of PD, only MMT reduced fall frequency after the intervention.

Trial registration: ClinicalTrials.gov NCT02538029.

Keywords: dual task; exercise; gait; neurology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control*
  • Adult
  • Aged
  • Cognition
  • Exercise / physiology
  • Exercise Therapy / methods*
  • Female
  • Gait / physiology*
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / physiopathology
  • Parkinson Disease / psychology
  • Parkinson Disease / rehabilitation*
  • Postural Balance / physiology*

Associated data

  • ClinicalTrials.gov/NCT02538029