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A Multifactorial Exercise Program to Reduce Falls in People With Parkinson Disease

Primary Purpose

Parkinson Disease

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Balance & Strengthening Exercises
Sponsored by
Boston University Charles River Campus
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Parkinson Disease focused on measuring Postural Instability (falling), Gait Disturbances (e.g., freezing), Bradykinesia (slowness of movement), rigidity

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • have a diagnosis of idiopathic Parkinson's disease (using UK Brain Bank Criteria)
  • have a Hoehn & Yahr stage of 2-4 during the "ON" state
  • Mini mental status score > 26
  • be 40 years of age or older, so as to represent the typical age range of PD
  • be on a stable dose of Parkinson's medications for at least 2 weeks prior to study onset and during the 3 month study period.
  • have experienced at least one fall in the past 3 months and greater or equal to 2 falls in the past one-year (A fall was defined as an unexpected event where the person inadvertently came to rest on the ground or other lower level not due to a major intrinsic or extrinsic event)
  • able to walk without physical assistance or an assistive device for at least 5 continuous minutes
  • able to understand, communicate with and be understood by recruitment personnel
  • able to attend the exercise program twice per week at Sargent College
  • be interested in participating and provide informed consent

Exclusion Criteria:

  • have a diagnosis of atypical Parkinsonism
  • have a Hoehn & Yahr stage of 1 or 5
  • have had previous surgical management of PD (i.e., deep brain stimulation surgery; pallidotomy)
  • serious co-morbidities that may interfere with ability to participate in an exercise program (i.e., musculoskeletal, cardiovascular, and neurological (other than Parkinson's))
  • be pregnant

Sites / Locations

  • Center for Neurorehabilitation, College of Health & Rehabilitation Sciences, Sargent College, Boston University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Early Multi-Ex-PD

Late Multi-Ex-PD

Arm Description

Immediately following enrollment, subjects will participate in a group balance and strengthening program (Multi-Ex-PD) 2x/week for 90 minutes over 3 months within the Center for Neurorehabilitation at Sargent College. Each of the exercises consists of a progression which ranges from less challenging to more challenging. The program will be individualized to the subject to appropriately match their abilities. Each subject will be progressed to a more challenging exercise once specific criteria are met. Resistance for the strengthening exercises will be applied using weighted vests.

Three months after enrollment, subjects will participate in a group balance and strengthening program (Multi-Ex-PD) 2x/week for 90 minutes over 3 months within the Center for Neurorehabilitation at Sargent College. Each of the exercises consists of a progression which ranges from less challenging to more challenging. The program will be individualized to the subject to appropriately match their abilities. Each subject will be progressed to a more challenging exercise once specific criteria are met. Resistance for the strengthening exercises will be applied using weighted vests.

Outcomes

Primary Outcome Measures

Falls Diary
Subjects will be asked to record each falling episode in the falls diary at the time of the fall or as soon as possible in relation to the actual time that the fall occurred. Subjects will be interviewed regarding fall episodes at each treatment session.

Secondary Outcome Measures

Change in Activities-specific Balance Confidence
Activities-specific Balance Confidence (ABC) Scale is a self-administered questionnaire in which subjects rate their level of confidence in performing a series of 16 activities.
Change in Falls Self-Efficacy
The Falls Self-Efficacy Scale is a self-administered questionnaire in which subjects rate their level of concern about falling when performing designated activities.
Change in Balance Evaluation Systems Test (BESTest)
The Balance Evaluation Systems Test (BESTest) is a 36 item test which is used to assess postural control / balance. Subjects are asked to perform a series of tasks such as sitting and leaning, standing on compliant and noncompliant surfaces, stepping forward, backward and to the side and walking on level and unlevel surfaces, while turning the head and while negotiating obstacles.
Change in Six-Minute Walk Test
The six-minute walk test (6MWT) is a measure of the distance a participant walks in a 6 minute time period. The 6-minute walk test is a safe, simple and useful measure of walking ability in patients with Parkinson's disease. The test will be carried out on level, obstacle-free enclosed corridors.
Change in Freezing of Gait Questionnaire
The Freezing of Gait Questionnaire (FOG) is a 6-item test in which the patient is interviewed and asked questions about their walking ability.
Change in Unified Parkinson's Disease Rating Scale
Section I, II, III and IV of the Unified Parkinson's Disease Rating Scale (UPDRS) will be utilized to assess nonmotor and motor signs.
Change in Scales for Outcomes in Parkinson Disease
The Scales for Outcomes in Parkinson Disease (SCOPA-AUT) consists of 26 items assessing autonomic function including gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor and sexual function.
Change in Parkinson's Disease Questionnaire-39
The Parkinson's Disease Questionnaire-39 (PDQ-39) is a quality of life instrument that contains 39-self-report items and was specifically developed for people with Parkinson's disease. The PDQ-39 measures the degree of healthy, competent, and satisfying participation in daily life activities.
Change in Beck Anxiety Inventory
The Beck Anxiety Inventory (BAI) is a measure of the severity of anxiety in adolescents and adults. The items assess typical features of anxiety, and the measure.
Changes in Beck Depression Inventory Second Edition
The Beck Depression Inventory Second Edition (BDI-II) is a measure of the severity of depression in adolescents and adults. The items target common symptoms of depression.
Changes in Penn State Worry Questionnaire
The Penn State Worry Questionnaire (PSWQ) is a measure of the worry characteristic of generalized anxiety disorder (GAD). Specifically, this measure of pathological worry assesses three areas of worry (generality, excessiveness, and uncontrollability).
Change in Panic Disorder Severity Scale
The Panic Disorder Severity Scale (PDSS) is a questionnaire designed to measure the overall severity of panic disorder. The items assess the severity of seven dimensions of panic disorder and associated symptoms: frequency of panic attacks, distress during panic attacks, panic-focused anticipatory anxiety, phobic avoidance of situations, phobic avoidance of physical sensations, and impairment and interference in work and social functioning.
Changes in Anxiety Sensitivity Index
The Anxiety Sensitivity Index (ASI) is an instrument on which respondents rate the degree to which they fear negative consequences resulting from anxiety symptoms. It yields a total score, representing the global-order anxiety sensitivity factor, as well as three lower-order factor scores, representing physical, psychological, and social concerns.
Changes in Social Phobia Inventor
The Social Phobia Inventory (SPIN) is a self-report questionnaire used to measure symptoms of social phobia (or social anxiety disorder). The SPIN specifically evaluates the spectrum of fear (e.g. fear of being embarrassed), avoidance (e.g. avoidance of parties), and physiological (e.g. blushing) symptoms associated with social phobia.
Changes in Social Interaction Anxiety Scale
The Social Interaction Anxiety Scale (SIAS) is a self-report questionnaire used to measure general fears of social interaction and fears of being scrutinized during activities and performance tasks. The scale is intended to measure affective, behavioral, and cognitive reactions in 20 social interaction situations.

Full Information

First Posted
November 24, 2014
Last Updated
July 18, 2017
Sponsor
Boston University Charles River Campus
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1. Study Identification

Unique Protocol Identification Number
NCT02302144
Brief Title
A Multifactorial Exercise Program to Reduce Falls in People With Parkinson Disease
Official Title
A Multifactorial Exercise Program to Reduce Falls in People With Parkinson Disease
Study Type
Interventional

2. Study Status

Record Verification Date
July 2017
Overall Recruitment Status
Completed
Study Start Date
December 2011 (undefined)
Primary Completion Date
June 2013 (Actual)
Study Completion Date
June 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Boston University Charles River Campus

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objective of this study is to investigate the effects of a theoretically driven, highly challenging exercise program (balance and strengthening exercises) in reducing fall rate, improving balance and reducing fear of falling in persons with Parkinson's disease. In this pilot, randomized, cross-over study, 32 participants with Parkinson disease will be randomly assigned to either an early start (immediately following enrollment) or late start (3 months after enrollment) multifactorial exercise program which will meet 2 times per week for 1.5 hours over 3 months. The exercise program will consist of balance and strengthening exercises which will be individualized depending on the ability of each participant. Fall rate, balance, walking ability, fear of falling, mood, anxiety, and quality of life will be measured prior to the start, at 3 months and 6 months after enrollment. Subjects will be enrolled for 6-7 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Parkinson Disease
Keywords
Postural Instability (falling), Gait Disturbances (e.g., freezing), Bradykinesia (slowness of movement), rigidity

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Early Multi-Ex-PD
Arm Type
Experimental
Arm Description
Immediately following enrollment, subjects will participate in a group balance and strengthening program (Multi-Ex-PD) 2x/week for 90 minutes over 3 months within the Center for Neurorehabilitation at Sargent College. Each of the exercises consists of a progression which ranges from less challenging to more challenging. The program will be individualized to the subject to appropriately match their abilities. Each subject will be progressed to a more challenging exercise once specific criteria are met. Resistance for the strengthening exercises will be applied using weighted vests.
Arm Title
Late Multi-Ex-PD
Arm Type
Experimental
Arm Description
Three months after enrollment, subjects will participate in a group balance and strengthening program (Multi-Ex-PD) 2x/week for 90 minutes over 3 months within the Center for Neurorehabilitation at Sargent College. Each of the exercises consists of a progression which ranges from less challenging to more challenging. The program will be individualized to the subject to appropriately match their abilities. Each subject will be progressed to a more challenging exercise once specific criteria are met. Resistance for the strengthening exercises will be applied using weighted vests.
Intervention Type
Behavioral
Intervention Name(s)
Balance & Strengthening Exercises
Intervention Description
Progressive balance and strengthening exercises conducted in a group format yet tailored to each individual
Primary Outcome Measure Information:
Title
Falls Diary
Description
Subjects will be asked to record each falling episode in the falls diary at the time of the fall or as soon as possible in relation to the actual time that the fall occurred. Subjects will be interviewed regarding fall episodes at each treatment session.
Time Frame
6-7 Months
Secondary Outcome Measure Information:
Title
Change in Activities-specific Balance Confidence
Description
Activities-specific Balance Confidence (ABC) Scale is a self-administered questionnaire in which subjects rate their level of confidence in performing a series of 16 activities.
Time Frame
6-7 Months
Title
Change in Falls Self-Efficacy
Description
The Falls Self-Efficacy Scale is a self-administered questionnaire in which subjects rate their level of concern about falling when performing designated activities.
Time Frame
6-7 Months
Title
Change in Balance Evaluation Systems Test (BESTest)
Description
The Balance Evaluation Systems Test (BESTest) is a 36 item test which is used to assess postural control / balance. Subjects are asked to perform a series of tasks such as sitting and leaning, standing on compliant and noncompliant surfaces, stepping forward, backward and to the side and walking on level and unlevel surfaces, while turning the head and while negotiating obstacles.
Time Frame
6-7 Months
Title
Change in Six-Minute Walk Test
Description
The six-minute walk test (6MWT) is a measure of the distance a participant walks in a 6 minute time period. The 6-minute walk test is a safe, simple and useful measure of walking ability in patients with Parkinson's disease. The test will be carried out on level, obstacle-free enclosed corridors.
Time Frame
6-7 Months
Title
Change in Freezing of Gait Questionnaire
Description
The Freezing of Gait Questionnaire (FOG) is a 6-item test in which the patient is interviewed and asked questions about their walking ability.
Time Frame
6-7 Months
Title
Change in Unified Parkinson's Disease Rating Scale
Description
Section I, II, III and IV of the Unified Parkinson's Disease Rating Scale (UPDRS) will be utilized to assess nonmotor and motor signs.
Time Frame
6-7 Months
Title
Change in Scales for Outcomes in Parkinson Disease
Description
The Scales for Outcomes in Parkinson Disease (SCOPA-AUT) consists of 26 items assessing autonomic function including gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor and sexual function.
Time Frame
6-7 Months
Title
Change in Parkinson's Disease Questionnaire-39
Description
The Parkinson's Disease Questionnaire-39 (PDQ-39) is a quality of life instrument that contains 39-self-report items and was specifically developed for people with Parkinson's disease. The PDQ-39 measures the degree of healthy, competent, and satisfying participation in daily life activities.
Time Frame
6-7 Months
Title
Change in Beck Anxiety Inventory
Description
The Beck Anxiety Inventory (BAI) is a measure of the severity of anxiety in adolescents and adults. The items assess typical features of anxiety, and the measure.
Time Frame
6-7 Months
Title
Changes in Beck Depression Inventory Second Edition
Description
The Beck Depression Inventory Second Edition (BDI-II) is a measure of the severity of depression in adolescents and adults. The items target common symptoms of depression.
Time Frame
6-7 Months
Title
Changes in Penn State Worry Questionnaire
Description
The Penn State Worry Questionnaire (PSWQ) is a measure of the worry characteristic of generalized anxiety disorder (GAD). Specifically, this measure of pathological worry assesses three areas of worry (generality, excessiveness, and uncontrollability).
Time Frame
6-7 Months
Title
Change in Panic Disorder Severity Scale
Description
The Panic Disorder Severity Scale (PDSS) is a questionnaire designed to measure the overall severity of panic disorder. The items assess the severity of seven dimensions of panic disorder and associated symptoms: frequency of panic attacks, distress during panic attacks, panic-focused anticipatory anxiety, phobic avoidance of situations, phobic avoidance of physical sensations, and impairment and interference in work and social functioning.
Time Frame
6-7 Months
Title
Changes in Anxiety Sensitivity Index
Description
The Anxiety Sensitivity Index (ASI) is an instrument on which respondents rate the degree to which they fear negative consequences resulting from anxiety symptoms. It yields a total score, representing the global-order anxiety sensitivity factor, as well as three lower-order factor scores, representing physical, psychological, and social concerns.
Time Frame
6-7 Months
Title
Changes in Social Phobia Inventor
Description
The Social Phobia Inventory (SPIN) is a self-report questionnaire used to measure symptoms of social phobia (or social anxiety disorder). The SPIN specifically evaluates the spectrum of fear (e.g. fear of being embarrassed), avoidance (e.g. avoidance of parties), and physiological (e.g. blushing) symptoms associated with social phobia.
Time Frame
6-7 Months
Title
Changes in Social Interaction Anxiety Scale
Description
The Social Interaction Anxiety Scale (SIAS) is a self-report questionnaire used to measure general fears of social interaction and fears of being scrutinized during activities and performance tasks. The scale is intended to measure affective, behavioral, and cognitive reactions in 20 social interaction situations.
Time Frame
6-7 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: have a diagnosis of idiopathic Parkinson's disease (using UK Brain Bank Criteria) have a Hoehn & Yahr stage of 2-4 during the "ON" state Mini mental status score > 26 be 40 years of age or older, so as to represent the typical age range of PD be on a stable dose of Parkinson's medications for at least 2 weeks prior to study onset and during the 3 month study period. have experienced at least one fall in the past 3 months and greater or equal to 2 falls in the past one-year (A fall was defined as an unexpected event where the person inadvertently came to rest on the ground or other lower level not due to a major intrinsic or extrinsic event) able to walk without physical assistance or an assistive device for at least 5 continuous minutes able to understand, communicate with and be understood by recruitment personnel able to attend the exercise program twice per week at Sargent College be interested in participating and provide informed consent Exclusion Criteria: have a diagnosis of atypical Parkinsonism have a Hoehn & Yahr stage of 1 or 5 have had previous surgical management of PD (i.e., deep brain stimulation surgery; pallidotomy) serious co-morbidities that may interfere with ability to participate in an exercise program (i.e., musculoskeletal, cardiovascular, and neurological (other than Parkinson's)) be pregnant
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Terry Ellis, PhD, PT, NCS
Organizational Affiliation
Boston University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Center for Neurorehabilitation, College of Health & Rehabilitation Sciences, Sargent College, Boston University
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
19370674
Citation
Gillespie LD, Robertson MC, Gillespie WJ, Lamb SE, Gates S, Cumming RG, Rowe BH. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD007146. doi: 10.1002/14651858.CD007146.pub2.
Results Reference
background
PubMed Identifier
12023412
Citation
Wood BH, Bilclough JA, Bowron A, Walker RW. Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatry. 2002 Jun;72(6):721-5. doi: 10.1136/jnnp.72.6.721.
Results Reference
background
PubMed Identifier
15591480
Citation
Genever RW, Downes TW, Medcalf P. Fracture rates in Parkinson's disease compared with age- and gender-matched controls: a retrospective cohort study. Age Ageing. 2005 Jan;34(1):21-4. doi: 10.1093/ageing/afh203.
Results Reference
background
PubMed Identifier
16703587
Citation
Melton LJ 3rd, Leibson CL, Achenbach SJ, Bower JH, Maraganore DM, Oberg AL, Rocca WA. Fracture risk after the diagnosis of Parkinson's disease: Influence of concomitant dementia. Mov Disord. 2006 Sep;21(9):1361-7. doi: 10.1002/mds.20946.
Results Reference
background
PubMed Identifier
1553857
Citation
Johnell O, Melton LJ 3rd, Atkinson EJ, O'Fallon WM, Kurland LT. Fracture risk in patients with parkinsonism: a population-based study in Olmsted County, Minnesota. Age Ageing. 1992 Jan;21(1):32-8. doi: 10.1093/ageing/21.1.32.
Results Reference
background
PubMed Identifier
16866658
Citation
Temlett JA, Thompson PD. Reasons for admission to hospital for Parkinson's disease. Intern Med J. 2006 Aug;36(8):524-6. doi: 10.1111/j.1445-5994.2006.01123.x.
Results Reference
background
PubMed Identifier
10449550
Citation
Hely MA, Morris JG, Traficante R, Reid WG, O'Sullivan DJ, Williamson PM. The sydney multicentre study of Parkinson's disease: progression and mortality at 10 years. J Neurol Neurosurg Psychiatry. 1999 Sep;67(3):300-7. doi: 10.1136/jnnp.67.3.300.
Results Reference
background
PubMed Identifier
16097843
Citation
Spottke AE, Reuter M, Machat O, Bornschein B, von Campenhausen S, Berger K, Koehne-Volland R, Rieke J, Simonow A, Brandstaedter D, Siebert U, Oertel WH, Ulm G, Dodel R. Cost of illness and its predictors for Parkinson's disease in Germany. Pharmacoeconomics. 2005;23(8):817-36. doi: 10.2165/00019053-200523080-00007.
Results Reference
background
PubMed Identifier
17393068
Citation
Jacobs JV, Horak FB. Cortical control of postural responses. J Neural Transm (Vienna). 2007;114(10):1339-48. doi: 10.1007/s00702-007-0657-0. Epub 2007 Mar 29.
Results Reference
background
PubMed Identifier
8866492
Citation
Bloem BR, Beckley DJ, van Dijk JG, Zwinderman AH, Remler MP, Roos RA. Influence of dopaminergic medication on automatic postural responses and balance impairment in Parkinson's disease. Mov Disord. 1996 Sep;11(5):509-21. doi: 10.1002/mds.870110506.
Results Reference
background
PubMed Identifier
15031239
Citation
Chang JT, Morton SC, Rubenstein LZ, Mojica WA, Maglione M, Suttorp MJ, Roth EA, Shekelle PG. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ. 2004 Mar 20;328(7441):680. doi: 10.1136/bmj.328.7441.680.
Results Reference
background
PubMed Identifier
8078528
Citation
Tinetti ME, Baker DI, McAvay G, Claus EB, Garrett P, Gottschalk M, Koch ML, Trainor K, Horwitz RI. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994 Sep 29;331(13):821-7. doi: 10.1056/NEJM199409293311301.
Results Reference
background
PubMed Identifier
19235117
Citation
Rose DJ. Preventing falls among older adults: no "one size suits all" intervention strategy. J Rehabil Res Dev. 2008;45(8):1153-66.
Results Reference
background
PubMed Identifier
17119004
Citation
Ashburn A, Fazakarley L, Ballinger C, Pickering R, McLellan LD, Fitton C. A randomised controlled trial of a home based exercise programme to reduce the risk of falling among people with Parkinson's disease. J Neurol Neurosurg Psychiatry. 2007 Jul;78(7):678-84. doi: 10.1136/jnnp.2006.099333. Epub 2006 Nov 21.
Results Reference
background
PubMed Identifier
17588236
Citation
Pickering RM, Grimbergen YA, Rigney U, Ashburn A, Mazibrada G, Wood B, Gray P, Kerr G, Bloem BR. A meta-analysis of six prospective studies of falling in Parkinson's disease. Mov Disord. 2007 Oct 15;22(13):1892-900. doi: 10.1002/mds.21598.
Results Reference
background
PubMed Identifier
18295614
Citation
Ebersbach G, Edler D, Kaufhold O, Wissel J. Whole body vibration versus conventional physiotherapy to improve balance and gait in Parkinson's disease. Arch Phys Med Rehabil. 2008 Mar;89(3):399-403. doi: 10.1016/j.apmr.2007.09.031.
Results Reference
background
PubMed Identifier
16926210
Citation
Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing. 2006 Sep;35 Suppl 2:ii7-ii11. doi: 10.1093/ageing/afl077.
Results Reference
background
PubMed Identifier
17846069
Citation
Cakit BD, Saracoglu M, Genc H, Erdem HR, Inan L. The effects of incremental speed-dependent treadmill training on postural instability and fear of falling in Parkinson's disease. Clin Rehabil. 2007 Aug;21(8):698-705. doi: 10.1177/0269215507077269.
Results Reference
background
PubMed Identifier
20629134
Citation
Allen NE, Canning CG, Sherrington C, Lord SR, Latt MD, Close JC, O'Rourke SD, Murray SM, Fung VS. The effects of an exercise program on fall risk factors in people with Parkinson's disease: a randomized controlled trial. Mov Disord. 2010 Jul 15;25(9):1217-25. doi: 10.1002/mds.23082.
Results Reference
background
PubMed Identifier
16340099
Citation
Protas EJ, Mitchell K, Williams A, Qureshy H, Caroline K, Lai EC. Gait and step training to reduce falls in Parkinson's disease. NeuroRehabilitation. 2005;20(3):183-90.
Results Reference
background
PubMed Identifier
17082464
Citation
Dorsey ER, Constantinescu R, Thompson JP, Biglan KM, Holloway RG, Kieburtz K, Marshall FJ, Ravina BM, Schifitto G, Siderowf A, Tanner CM. Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology. 2007 Jan 30;68(5):384-6. doi: 10.1212/01.wnl.0000247740.47667.03. Epub 2006 Nov 2.
Results Reference
background
PubMed Identifier
26655100
Citation
Sparrow D, DeAngelis TR, Hendron K, Thomas CA, Saint-Hilaire M, Ellis T. Highly Challenging Balance Program Reduces Fall Rate in Parkinson Disease. J Neurol Phys Ther. 2016 Jan;40(1):24-30. doi: 10.1097/NPT.0000000000000111.
Results Reference
derived
Links:
URL
http://www.bu.edu/neurorehab/research/
Description
Center for Neurorehabilitation at Boston University

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A Multifactorial Exercise Program to Reduce Falls in People With Parkinson Disease

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