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 ?
Cueing training in the home improves gait-related mobility in Parkinson’s disease: the RESCUE trial
Objectives : Gait and mobility problems are difficult to treat in people with Parkinson ’s disease . The Rehabilitation in Parkinson ’s Disease : Strategies for Cueing ( RESCUE ) trial investigated the effects of a home physiotherapy programme based on rhythmical cueing on gait and gait-related activity . Methods : A single-blind r and omised crossover trial was set up , including 153 patients with Parkinson ’s disease aged between 41 and 80 years and in Hoehn and Yahr stage II – IV . Subjects allocated to early intervention ( n = 76 ) received a 3-week home cueing programme using a prototype cueing device , followed by 3 weeks without training . Patients allocated to late intervention ( n = 77 ) underwent the same intervention and control period in reverse order . After the initial 6 weeks , both groups had a 6-week follow-up without training .  Posture and gait scores ( PG scores ) measured at 3 , 6 and 12 weeks by blinded testers were the primary outcome measure . Secondary outcomes included specific measures on gait , freezing and balance , functional activities , quality of life and carer strain . Results : Small but significant improvements were found after intervention of 4.2 % on the PG scores ( p = 0.005 ) . Severity of freezing was reduced by 5.5 % in freezers only ( p = 0.007 ) . Gait speed ( p = 0.005 ) , step length ( p<0.001 ) and timed balance tests ( p = 0.003 ) improved in the full cohort . Other than a greater confidence to carry out functional activities ( Falls Efficacy Scale , p = 0.04 ) , no carry-over effects were observed in functional and quality of life domains . Effects of intervention had reduced considerably at 6-week follow-up . Conclusions : Cueing training in the home has specific effects on gait , freezing and balance . The decline in effectiveness of intervention effects underscores the need for permanent cueing devices and follow-up treatment . Cueing training may be a useful therapeutic adjunct to the overall management of gait disturbance in Parkinson ’s disease
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 ?