J Mov Disord.
2025 Apr;18(2):149-159. 10.14802/jmd.24237.
Feasibility of a Multidomain Intervention for Safe Mobility in People With Parkinson’s Disease and Recurrent Falls
- Allen NE
1 - Goh L1
- Canning CG1
- Sherrington C2,3
- Clemson L1
- Close JC4,5
- Lord SR4
- Lewis SJG6
- Edwards S1
- Harkness S1
- Savage R1
- Webster L1
- Zelma G1
- Paul SS1
- Affiliations
-
- 1Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- 2Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- 3Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia
- 4Neuroscience Research Australia, University of New South Wales, Sydney, Australia
- 5School of Clinical Medicine, University of New South Wales, Sydney, Australia
- 6Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- KMID: 2567160
- DOI: http://doi.org/10.14802/jmd.24237
Abstract
Objective
Mobility limitations and falls are common in people with Parkinson’s disease (PwP). Compared with exercise alone, a tailored, multidomain intervention has the potential to be more effective in improving mobility safety and preventing falls. This study aimed to explore the feasibility and potential effectiveness of a multidomain fall prevention intervention (Integrate) designed for PwP who experience frequent falls.
Methods
The home-based intervention was delivered over a span of 6 months by occupational therapists and physiotherapists. The personalized intervention included home fall hazard reduction, exercise, and safer mobility behavior training. The participants received 8 to 12 home visits and were supported by care-partners (when necessary) to participate in the intervention.
Results
Twenty-nine people (recruitment rate: 49%; drop-out rate: 10%) with moderate to advanced Parkinson’s disease, a history of recurrent falls, and mild to moderate cognitive impairment participated in the study, with 26 people completing the study. A moderate-to-high adherence to the intervention was observed, and there were no adverse events related to the intervention. Twenty-one (81%) participants met or exceeded their safer mobility goal based on the Goal Attainment Scale. The participants exhibited a median 1.0-point clinically meaningful improvement according to the Short Physical Performance Battery. An exploratory analysis revealed that fall rates were reduced by almost 50% in the 6-month follow-up period (incidence rate ratio: 0.51; 95% confidence interval 0.28–0.92).
Conclusion
A multidomain occupational therapy and physiotherapy intervention for PwP experiencing recurrent falls was feasible and appeared to improve mobility safety. A randomized trial powered to detect the effects of the intervention on falls and mobility is warranted.
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