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Review
. 2022 Jun 6;6(6):CD011574.
doi: 10.1002/14651858.CD011574.pub2.

Interventions for preventing falls in Parkinson's disease

Natalie E Allen  1 , Colleen G Canning  1 , Lorena Rosa S Almeida  2   3 , Bastiaan R Bloem  4 , Samyra Hj Keus  5   6 , Niklas Löfgren  1   7   8 , Alice Nieuwboer  9 , Geert Saf Verheyden  9 , Tiê P Yamato  10 , Catherine Sherrington  11
Affiliations
Review

Interventions for preventing falls in Parkinson's disease

Natalie E Allen et al. Cochrane Database Syst Rev. .

Abstract

Background: Most people with Parkinson's disease (PD) experience at least one fall during the course of their disease. Several interventions designed to reduce falls have been studied. An up-to-date synthesis of evidence for interventions to reduce falls in people with PD will assist with informed decisions regarding fall-prevention interventions for people with PD.

Objectives: To assess the effects of interventions designed to reduce falls in people with PD.

Search methods: CENTRAL, MEDLINE, Embase, four other databases and two trials registers were searched on 16 July 2020, together with reference checking, citation searching and contact with study authors to identify additional studies. We also conducted a top-up search on 13 October 2021.

Selection criteria: We included randomised controlled trials (RCTs) of interventions that aimed to reduce falls in people with PD and reported the effect on falls. We excluded interventions that aimed to reduce falls due to syncope.

Data collection and analysis: We used standard Cochrane Review procedures. Primary outcomes were rate of falls and number of people who fell at least once. Secondary outcomes were the number of people sustaining one or more fall-related fractures, quality of life, adverse events and economic outcomes. The certainty of the evidence was assessed using GRADE.

Main results: This review includes 32 studies with 3370 participants randomised. We included 25 studies of exercise interventions (2700 participants), three studies of medication interventions (242 participants), one study of fall-prevention education (53 participants) and three studies of exercise plus education (375 participants). Overall, participants in the exercise trials and the exercise plus education trials had mild to moderate PD, while participants in the medication trials included those with more advanced disease. All studies had a high or unclear risk of bias in one or more items. Illustrative risks demonstrating the absolute impact of each intervention are presented in the summary of findings tables. Twelve studies compared exercise (all types) with a control intervention (an intervention not thought to reduce falls, such as usual care or sham exercise) in people with mild to moderate PD. Exercise probably reduces the rate of falls by 26% (rate ratio (RaR) 0.74, 95% confidence interval (CI) 0.63 to 0.87; 1456 participants, 12 studies; moderate-certainty evidence). Exercise probably slightly reduces the number of people experiencing one or more falls by 10% (risk ratio (RR) 0.90, 95% CI 0.80 to 1.00; 932 participants, 9 studies; moderate-certainty evidence). We are uncertain whether exercise makes little or no difference to the number of people experiencing one or more fall-related fractures (RR 0.57, 95% CI 0.28 to 1.17; 989 participants, 5 studies; very low-certainty evidence). Exercise may slightly improve health-related quality of life immediately following the intervention (standardised mean difference (SMD) -0.17, 95% CI -0.36 to 0.01; 951 participants, 5 studies; low-certainty evidence). We are uncertain whether exercise has an effect on adverse events or whether exercise is a cost-effective intervention for fall prevention. Three studies trialled a cholinesterase inhibitor (rivastigmine or donepezil). Cholinesterase inhibitors may reduce the rate of falls by 50% (RaR 0.50, 95% CI 0.44 to 0.58; 229 participants, 3 studies; low-certainty evidence). However, we are uncertain if this medication makes little or no difference to the number of people experiencing one or more falls (RR 1.01, 95% CI 0.90 to 1.14230 participants, 3 studies) and to health-related quality of life (EQ5D Thermometer mean difference (MD) 3.00, 95% CI -3.06 to 9.06; very low-certainty evidence). Cholinesterase inhibitors may increase the rate of non fall-related adverse events by 60% (RaR 1.60, 95% CI 1.28 to 2.01; 175 participants, 2 studies; low-certainty evidence). Most adverse events were mild and transient in nature. No data was available regarding the cost-effectiveness of medication for fall prevention. We are uncertain of the effect of education compared to a control intervention on the number of people who fell at least once (RR 10.89, 95% CI 1.26 to 94.03; 53 participants, 1 study; very low-certainty evidence), and no data were available for the other outcomes of interest for this comparisonWe are also uncertain (very low-certainty evidence) whether exercise combined with education makes little or no difference to the number of falls (RaR 0.46, 95% CI 0.12 to 1.85; 320 participants, 2 studies), the number of people sustaining fall-related fractures (RR 1.45, 95% CI 0.40 to 5.32,320 participants, 2 studies), or health-related quality of life (PDQ39 MD 0.05, 95% CI -3.12 to 3.23, 305 participants, 2 studies). Exercise plus education may make little or no difference to the number of people experiencing one or more falls (RR 0.89, 95% CI 0.75 to 1.07; 352 participants, 3 studies; low-certainty evidence). We are uncertain whether exercise combined with education has an effect on adverse events or is a cost-effective intervention for fall prevention. AUTHORS' CONCLUSIONS: Exercise interventions probably reduce the rate of falls, and probably slightly reduce the number of people falling in people with mild to moderate PD. Cholinesterase inhibitors may reduce the rate of falls, but we are uncertain if they have an effect on the number of people falling. The decision to use these medications needs to be balanced against the risk of non fall-related adverse events, though these adverse events were predominantly mild or transient in nature. Further research in the form of large, high-quality RCTs are required to determine the relative impact of different types of exercise and different levels of supervision on falls, and how this could be influenced by disease severity. Further work is also needed to increase the certainty of the effects of medication and further explore falls prevention education interventions both delivered alone and in combination with exercise.

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Conflict of interest statement

No review author was involved in study selection or processing of risk of bias of any trials in which they are involved.

Several authors (CS, NA, CC) are currently running trials of fall‐prevention interventions; including the following ongoing trial in this review (ACTRN12619000415101).

NA is an author of several trials considered in this review, including two included trials (Canning 2015a, Song 2018).

CC is an author of several trials considered in this review, including three included trials (Canning 2015a, Paul 2014, Song 2018).

LA has no known conflict of interest.

BB is an author of several trials considered in this review, including two included trials (Munneke 2010, Mirelman 2016).

SK is an author of several trials considered in this review, including one included trial (Munneke 2010).

NL has no known conflicts of interest.

AN is an author of several trials considered in this review, including one included trial (Mirelman 2016).

GV has no known conflicts of interest.

TP has no known conflicts of interest.

CS is an author of several trials considered in this review, including three included trials (Canning 2015a, Paul 2014, Song 2018).

Figures

1
1
Study flow diagram. a Ashburn 2019 was identified through contacting researchers in the field.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
4
4
Funnel plot of comparison: 1 Exercise vs control (rate of falls), outcome: 1.1 Rate of falls.
5
5
Funnel plot of comparison: 2 Exercise vs control (number of fallers), outcome: 2.1 Number of fallers.
1.1
1.1. Analysis
Comparison 1: Exercise vs control (rate of falls), Outcome 1: Rate of falls
1.2
1.2. Analysis
Comparison 1: Exercise vs control (rate of falls), Outcome 2: Rate of falls subgrouped by ProFaNE exercise categories
1.3
1.3. Analysis
Comparison 1: Exercise vs control (rate of falls), Outcome 3: Rate of falls ‐ subgrouped by % supervision (100% supervision vs <100% supervision)
1.4
1.4. Analysis
Comparison 1: Exercise vs control (rate of falls), Outcome 4: Rate of falls ‐ subgrouped by baseline fall risk (increased fall risk vs fall risk not specified)
1.5
1.5. Analysis
Comparison 1: Exercise vs control (rate of falls), Outcome 5: Rate of falls ‐ pooled disease severity subgroup analyses_UPDRS
2.1
2.1. Analysis
Comparison 2: Exercise vs control (number of fallers), Outcome 1: Number of fallers
2.2
2.2. Analysis
Comparison 2: Exercise vs control (number of fallers), Outcome 2: Number of fallers subgrouped by ProFaNE exercise categories
2.3
2.3. Analysis
Comparison 2: Exercise vs control (number of fallers), Outcome 3: Number of fallers ‐ subgrouped by % supervision (100% supervision vs <100% supervision)
2.4
2.4. Analysis
Comparison 2: Exercise vs control (number of fallers), Outcome 4: Number of fallers ‐ subgrouped by baseline fall risk (increased fall risk vs fall risk not specified)
2.5
2.5. Analysis
Comparison 2: Exercise vs control (number of fallers), Outcome 5: Number of fallers ‐ pooled disease severity subgroup analyses
3.1
3.1. Analysis
Comparison 3: Exercise vs control (number of people sustaining one or more fall‐related fractures), Outcome 1: Number of people sustaining one or more fall‐related fractures
4.1
4.1. Analysis
Comparison 4: Exercise vs control (health‐related quality of life), Outcome 1: Health‐related quality of life ‐ combined measures post intervention
4.2
4.2. Analysis
Comparison 4: Exercise vs control (health‐related quality of life), Outcome 2: Health‐related quality of life ‐ combined measures follow‐up
5.1
5.1. Analysis
Comparison 5: Exercise vs exercise (rate of falls), Outcome 1: Rate of falls, different types of exercise compared
6.1
6.1. Analysis
Comparison 6: Exercise vs exercise (number of fallers), Outcome 1: Number of fallers, different types of exercise compared
7.1
7.1. Analysis
Comparison 7: Exercise vs exercise (health‐related quality of life), Outcome 1: Quality of life ‐ combined measures post intervention, different types of exercise compared
7.2
7.2. Analysis
Comparison 7: Exercise vs exercise (health‐related quality of life), Outcome 2: Quality of life ‐ combined measures follow‐up, different types of exercise compared
8.1
8.1. Analysis
Comparison 8: Cholinesterase inhibitor vs placebo (rate of falls), Outcome 1: Rate of falls
8.2
8.2. Analysis
Comparison 8: Cholinesterase inhibitor vs placebo (rate of falls), Outcome 2: Rate of falls ‐ subgrouped by medication
9.1
9.1. Analysis
Comparison 9: Cholinesterase inhibitor vs placebo (number of fallers), Outcome 1: Number of fallers
9.2
9.2. Analysis
Comparison 9: Cholinesterase inhibitor vs placebo (number of fallers), Outcome 2: Number of fallers ‐ subgrouped by medication
10.1
10.1. Analysis
Comparison 10: Cholinesterase inhibitor vs placebo (health‐related quality of life), Outcome 1: Quality of life EQ5D thermometer post intervention
10.2
10.2. Analysis
Comparison 10: Cholinesterase inhibitor vs placebo (health‐related quality of life), Outcome 2: Quality of life EQ5D Index Score post intervention
11.1
11.1. Analysis
Comparison 11: Cholinesterase inhibitor vs placebo (rate of adverse events excluding falls), Outcome 1: Rate of adverse events excluding falls
12.1
12.1. Analysis
Comparison 12: Education vs usual care (number of fallers), Outcome 1: Number of fallers
13.1
13.1. Analysis
Comparison 13: Exercise and education vs control (rate of falls), Outcome 1: Rate of falls
14.1
14.1. Analysis
Comparison 14: Exercise and education vs control (number of fallers), Outcome 1: Number of fallers
15.1
15.1. Analysis
Comparison 15: Exercise and education vs control (number of people sustaining one or more fall‐related fractures), Outcome 1: Number of people sustaining one or more fall‐related fractures
16.1
16.1. Analysis
Comparison 16: Exercise and education vs control (health‐related quality of life), Outcome 1: Health‐related quality of life ‐ Parkinson's Disease Questionnaire (PDQ39) post intervention
16.2
16.2. Analysis
Comparison 16: Exercise and education vs control (health‐related quality of life), Outcome 2: Health‐related quality of life ‐ Parkinson's Disease Questionnaire (PDQ39) at follow‐up
17.1
17.1. Analysis
Comparison 17: Exercise and education vs exercise and education (rate of falls), Outcome 1: Rate of falls
18.1
18.1. Analysis
Comparison 18: Exercise and education vs exercise and education (number of fallers), Outcome 1: Number of fallers
19.1
19.1. Analysis
Comparison 19: Exercise and education vs exercise and education (number of people sustaining one or more fall‐related fractures), Outcome 1: Number of people sustaining one or more fall‐related fractures
20.1
20.1. Analysis
Comparison 20: Exercise and education vs exercise and education (health‐related quality of life), Outcome 1: Health‐related quality of life ‐ Parkinson's Disease Questionnaire (PDQ39) post intervention
20.2
20.2. Analysis
Comparison 20: Exercise and education vs exercise and education (health‐related quality of life), Outcome 2: Health‐related quality of life ‐ Parkinson's Disease Questionnaire (PDQ39) at follow‐up
21.1
21.1. Analysis
Comparison 21: Sensitivity analysis 1: excluding studies at a high risk of bias in any item, Outcome 1: Rate of falls ‐ exercise vs control
21.2
21.2. Analysis
Comparison 21: Sensitivity analysis 1: excluding studies at a high risk of bias in any item, Outcome 2: Number of fallers ‐ exercise vs control
21.3
21.3. Analysis
Comparison 21: Sensitivity analysis 1: excluding studies at a high risk of bias in any item, Outcome 3: Rate of falls ‐ cholinesterase inhibitor vs placebo
21.4
21.4. Analysis
Comparison 21: Sensitivity analysis 1: excluding studies at a high risk of bias in any item, Outcome 4: Number of fallers ‐ cholinesterase inhibitor vs placebo
21.5
21.5. Analysis
Comparison 21: Sensitivity analysis 1: excluding studies at a high risk of bias in any item, Outcome 5: Rate of falls ‐ exercise and education vs control
21.6
21.6. Analysis
Comparison 21: Sensitivity analysis 1: excluding studies at a high risk of bias in any item, Outcome 6: Number of fallers ‐ exercise and education vs control
22.1
22.1. Analysis
Comparison 22: Sensitivity analysis 2: excluding studies with unclear or high risk of bias on random sequence generation, Outcome 1: Rate of falls ‐ exercise vs control
22.2
22.2. Analysis
Comparison 22: Sensitivity analysis 2: excluding studies with unclear or high risk of bias on random sequence generation, Outcome 2: Number of fallers ‐ exercise vs control
22.3
22.3. Analysis
Comparison 22: Sensitivity analysis 2: excluding studies with unclear or high risk of bias on random sequence generation, Outcome 3: Rate of falls ‐ cholinesterase inhibitor vs placebo
22.4
22.4. Analysis
Comparison 22: Sensitivity analysis 2: excluding studies with unclear or high risk of bias on random sequence generation, Outcome 4: Number of fallers ‐ cholinesterase inhibitor vs placebo
23.1
23.1. Analysis
Comparison 23: Sensitivity analysis 3: excluding studies with unclear or high risk of bias on allocation concealment, Outcome 1: Rate of falls ‐ exercise vs control
23.2
23.2. Analysis
Comparison 23: Sensitivity analysis 3: excluding studies with unclear or high risk of bias on allocation concealment, Outcome 2: Number of fallers ‐ exercise vs control
23.3
23.3. Analysis
Comparison 23: Sensitivity analysis 3: excluding studies with unclear or high risk of bias on allocation concealment, Outcome 3: Rate of falls ‐ cholinesterase inhibitor vs placebo
23.4
23.4. Analysis
Comparison 23: Sensitivity analysis 3: excluding studies with unclear or high risk of bias on allocation concealment, Outcome 4: Number of fallers ‐ cholinesterase inhibitor vs placebo
23.5
23.5. Analysis
Comparison 23: Sensitivity analysis 3: excluding studies with unclear or high risk of bias on allocation concealment, Outcome 5: Number of fallers ‐ exercise and education vs control
24.1
24.1. Analysis
Comparison 24: Sensitivity analysis 4, excluding studies with unclear or high risk of bias on assessor blinding, Outcome 1: Rate of falls ‐ exercise vs control
24.2
24.2. Analysis
Comparison 24: Sensitivity analysis 4, excluding studies with unclear or high risk of bias on assessor blinding, Outcome 2: Number of fallers ‐ exercise vs control
24.3
24.3. Analysis
Comparison 24: Sensitivity analysis 4, excluding studies with unclear or high risk of bias on assessor blinding, Outcome 3: Rate of falls ‐ exercise and education vs control
24.4
24.4. Analysis
Comparison 24: Sensitivity analysis 4, excluding studies with unclear or high risk of bias on assessor blinding, Outcome 4: Number of fallers ‐ exercise and education vs control
25.1
25.1. Analysis
Comparison 25: Sensitivity analysis 5, excluding studies with unclear or high risk of bias on incomplete outcome data, Outcome 1: Rate of falls ‐ exercise vs control
25.2
25.2. Analysis
Comparison 25: Sensitivity analysis 5, excluding studies with unclear or high risk of bias on incomplete outcome data, Outcome 2: Number of fallers ‐ exercise vs control
25.3
25.3. Analysis
Comparison 25: Sensitivity analysis 5, excluding studies with unclear or high risk of bias on incomplete outcome data, Outcome 3: Rate of falls ‐ cholinesterase inhibitor vs placebo
25.4
25.4. Analysis
Comparison 25: Sensitivity analysis 5, excluding studies with unclear or high risk of bias on incomplete outcome data, Outcome 4: Number of fallers ‐ cholinesterase inhibitor vs placebo
25.5
25.5. Analysis
Comparison 25: Sensitivity analysis 5, excluding studies with unclear or high risk of bias on incomplete outcome data, Outcome 5: Rate of falls ‐ exercise and education vs control
26.1
26.1. Analysis
Comparison 26: Sensitivity analysis 6, excluding studies with less than three months falls monitoring, Outcome 1: Rate of falls ‐ exercise vs control
26.2
26.2. Analysis
Comparison 26: Sensitivity analysis 6, excluding studies with less than three months falls monitoring, Outcome 2: Number of fallers ‐ exercise vs control
27.1
27.1. Analysis
Comparison 27: Sensitivity analysis 7, excluding comparisons responsible for the high level of heterogeneity, Outcome 1: Number of fallers ‐ cholinesterase inhibitor vs placebo
27.2
27.2. Analysis
Comparison 27: Sensitivity analysis 7, excluding comparisons responsible for the high level of heterogeneity, Outcome 2: Rate of falls ‐ exercise and education vs control
28.1
28.1. Analysis
Comparison 28: Sensitivity analysis 8, fixed‐effect meta‐analysis, Outcome 1: Rate of falls ‐ exercise vs control
28.2
28.2. Analysis
Comparison 28: Sensitivity analysis 8, fixed‐effect meta‐analysis, Outcome 2: Number of fallers ‐ exercise vs control
28.3
28.3. Analysis
Comparison 28: Sensitivity analysis 8, fixed‐effect meta‐analysis, Outcome 3: Rate of falls ‐ exercise and education vs control
28.4
28.4. Analysis
Comparison 28: Sensitivity analysis 8, fixed‐effect meta‐analysis, Outcome 4: Number of fallers ‐ exercise and education vs control
29.1
29.1. Analysis
Comparison 29: Sensitivity analysis 9, random effects meta‐analysis, Outcome 1: Rate of falls ‐ cholinesterase inhibitor vs placebo
29.2
29.2. Analysis
Comparison 29: Sensitivity analysis 9, random effects meta‐analysis, Outcome 2: Number of fallers ‐ cholinesterase inhibitor vs placebo
30.1
30.1. Analysis
Comparison 30: Sensitivity analysis 10, reclassifying functional resistance training from resistance training to gait, balance and functional training, Outcome 1: Rate of falls ‐ exercise vs control
30.2
30.2. Analysis
Comparison 30: Sensitivity analysis 10, reclassifying functional resistance training from resistance training to gait, balance and functional training, Outcome 2: Number of fallers ‐ exercise vs control
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References

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    1. McGinley JL, Martin C, Huxham FE, Menz HB, Danoudis M, Murphy AT, et al. Feasibility, safety, and compliance in a randomized controlled trial of physical therapy for Parkinson's disease. Parkinson's Disease 2012;2012:1-8. [PMID: ] - PMC - PubMed
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    1. Morris ME, Menz HB, McGinley JL, Watts JJ, Huxham FE, Murphy AT, et al. f randomized controlled trial to reduce Falls in people with Parkinson's disease. Neurorehabilitation and Neural Repair 2015;29(8):777-85. [PMID: ] - PubMed
    1. Watts JJ, McGinley JL, Huxham F, Menz HB, Iansek R, Murphy AT, et al. Cost effectiveness of preventing falls and improving mobility in people with Parkinson disease: protocol for an economic evaluation alongside a clinical trial. BMC Geriatrics 2008;8(23):1-8. [PMID: ] - PMC - PubMed
Morris 2017 {published data only}
    1. Morris ME, Martin C, McGinley JL, Huxham FE, Menz HB, Taylor NF, et al. Protocol for a home-based integrated physical therapy program to reduce falls and improve mobility in people with Parkinson's disease. BMC Neurology 2012;12:54. [PMID: ] - PMC - PubMed
    1. Morris ME, Taylor NF, Watts JJ, Evans A, Horne M, Kempster P, et al. A home program of strength training, movement strategy training and education did not prevent falls in people with Parkinson's disease: a randomised trial. Journal of Physiotherapy 2017;63(2):94-100. [PMID: ] - PubMed
Munneke 2010 {published data only (unpublished sought but not used)}
    1. Keus SH, Nijkrake MJ, Borm GF, Kwakkel G, Roos RA, Berendse HW, et al. The ParkinsonNet trial: design and baseline characteristics. Movement Disorders 2010;25(7):830-7. [PMID: ] - PubMed
    1. Munneke M, Nijkrake MJ, Keus SH, Kwakkel G, Berendse HW, Roos RA, et al. Efficacy of community-based physiotherapy networks for patients with Parkinson's disease: a cluster randomised trial. Lancet Neurology 2010;9(1):46-54. [PMID: ] - PubMed
    1. Nijkrake MJ, Keus SH, Overeem S, Oostendorp RA, Vliet Vlieland TP, Mulleners W, et al. The ParkinsonNet concept: development, implementation and initial experience. Movement Disorders 2010;25(7):823-9. [PMID: ] - PubMed
Paul 2014 {published and unpublished data}
    1. Paul SS, Canning CG, Song J, Fung VS, Sherrington C. Leg muscle power is enhanced by training in people with Parkinson'sdisease: a randomized controlled trial. Clinical Rehabilitation 2014;28(3):275-88. [PMID: ] - PubMed
Pelosin 2017 {published data only (unpublished sought but not used)}
    1. Pelosin E, Avanzino L, Barella R, Bet C, Magioncalda E, Trompetto C, et al. Treadmill training frequency influences walking improvement in subjects with Parkinson's disease: a randomized pilot study. European Journal of Physical and Rehabilitation Medicine 2017;53(2):201-8. - PubMed
Penko 2019 {published data only (unpublished sought but not used)}
    1. Penko AL, Barkley JE, Rosenfeldt AB, Alberts JL. Multimodal training reduces fall frequency as physical activity increases in individuals with Parkinson's disease. Journal of Physical Activity and Health 2019;16:1085-91. - PubMed
    1. Rosenfeldt A, Penko AL, Bazyk AS, Streicher MC, Dey T, Alberts JL. The 2-min walk test detects dual-task deficits in individuals with Parkinson's disease. Journal of Aging and Physical Activity 2019;27(4):843-7. - PubMed
    1. Rosenfeldt AB, Penko AL, Streicher MC, Zimmerman NM, Miller Koop M, Alberts JL. Improvements in temporal and postural aspects of gait vary following single- and multi-modal training in individuals with Parkinson's disease. Parkinsonism and Related Disorders 2019;64:280-5. - PubMed
Protas 2005 {published data only (unpublished sought but not used)}
    1. 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. [PMID: ] - PubMed
Ricciardi 2015 {published data only (unpublished sought but not used)}
    1. Ricciardi L, Ricciardi D, Lena F, Plotnik M, Petracca M, Barricella S, et al. Working on asymmetry in Parkinson's disease: randomized, controlled pilot study. Neurological Sciences 2015;36(8):1337-43. [PMID: ] - PubMed
Sedaghati 2016 {published data only (unpublished sought but not used)}
    1. Sedaghati P, Daneshmandi H, Karimi N, Barati A. A selective corrective exercise to decrease falling and improve functional balance in idiopathic Parkinson's disease. Trauma Monthly 2016;21(1):e23573. [PMID: ] - PMC - PubMed
Shen 2015 {published data only}
    1. Shen X, Mak MK. Balance and gait training with augmented feedback improves balance confidence in people with Parkinson's disease: a randomized controlled trial. Neurorehabilitation and Neural Repair 2014;28(6):524-35. [PMID: ] - PubMed
    1. Shen X, Mak MK. Technology-assisted balance and gait training reduces falls in patients with Parkinson's disease: a randomized controlled trial with 12-month follow-up. Neurorehabilitation and Neural Repair 2015;29(2):103-11. [PMID: ] - PubMed
Smania 2010 {published data only (unpublished sought but not used)}
    1. Smania N, Corato E, Tinazzi M, Stanzani C, Fiaschi A, Girardi P, et al. Effect of balance training on postural instability in patients with idiopathic Parkinson's disease. Neuroherabilitation and Neural Repair 2010;24(9):826-34. [PMID: ] - PubMed
Song 2018 {published data only}
    1. Song J, Paul SS, Caetano MJ, Smith S, Dibble LE, Love R, et al. Home-based step training using videogame technology in people with Parkinson's disease: a single-blinded randomised controlled trial. Clinical Rehabilitation 2018;32(3):299-311. - PubMed
Thaut 2019 {published and unpublished data}
    1. Thaut MH, Rice RR, Braun Janzen T, Hurt-Thaut CP, McIntosh GC. Rhythmic auditory stimulation for reduction of falls in Parkinson's disease: a randomized controlled study. Clinical Rehabilitation 2019;33(1):34-43. - PubMed
Volpe 2014a {published data only (unpublished sought but not used)}
    1. Volpe D, Giantin MG, Fasano A. A wearable proprioceptive stabilizer (Equistasi®) for rehabilitation of postural instability in Parkinson's disease: a phase II randomized double-blind, double-dummy, controlled study. PLOS One 2014;9(11):e112065. [PMID: ] - PMC - PubMed
Volpe 2014b {published data only (unpublished sought but not used)}
    1. Volpe D, Giantin MG, Maestri R, Frazzitta G. Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson's disease: a randomized controlled pilot study. Clinical Rehabilitation 2014;28(12):1210-7. [PMID: ] - PubMed
Ward 2004 {published data only (unpublished sought but not used)}
    1. Ward CD, Turpin G, Dewey ME, Fleming S, Hurwitz B, Ratib S, et al. Education for people with progressive neurological conditions can have negative effects: evidence from a randomized controlled trial. Clinical Rehabilitation 2004;18(7):717-25. [PMID: ] - PubMed
Wong‐Yu 2015 {published data only}
    1. Wong-Yu IS, Mak MK. Task- and context-specific balance training program enhances dynamic balance and functional performance in parkinsonian nonfallers: a randomized controlled trial with six-month follow-up. Archives of Physical Medicine and Rehabilitation 2015;96(12):2103-11. [PMID: ] - PubMed
    1. Wong-Yu ISK, Mak MK. Multi-dimensional balance training programme improves balance and gait performance in people with Parkinson's disease: a pragmatic randomized controlled trial with 12-month follow-up. Parkinsonism and Related Disorders 2015;21(6):615-21. [PMID: ] - PubMed
    1. Wong-Yu ISK, Mak MK. Multisystem balance training reduces injurious fall risk in Parkinson disease. American Journal of Physical Medicine and Rehabilitation 2019;98(3):239-44. - PubMed

References to studies excluded from this review

Allen 2010 {published data only}
    1. Allen NE, Canning CG, Sherrington C, Lord SR, Latt M D, Close JC, et al. The effects of an exercise program on fall risk factors in people with Parkinson's disease: a randomized controlled trial. Movement Disorders 2010;25(9):1217-25. - PubMed
Bevilacqua 2020 {published data only}
    1. Bevilacqua R, Maranesi E, Di Rosa M, Luzi R, Casoni E, Rinaldi N, et al. Rehabilitation of older people with Parkinson's disease: an innovative protocol for RCT study to evaluate the potential of robotic-based technologies. BMC Neurology 2020;20(1):186. - PMC - PubMed
Bueno 2017 {published data only}
    1. Bueno ME, dos Reis Andrello AC, Terra MB, dos Santos HB, Marquioli JM, Santos SM. Comparison of three physical therapy interventions with an emphasis on the gait of individuals with Parkinson's disease [Fisioterapia em Movimento]. [Physical Therapy in Movement] 2017;30(4):691-701.
Cakit 2007 {published data only}
    1. 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. Clinical Rehabilitation 2007;21(8):698-705. - PubMed
Calabro 2019 {published data only}
    1. Calabro RS, Naro A, Filoni S, Pullia M, Billeri L, Tomasello P, et al. Walking to your right music: a randomized controlled trial on the novel use of treadmill plus music in Parkinson's disease. Journal of Neuroengineering & Rehabilitation 2019;16(1):68. - PMC - PubMed
Celiker 2018 {published data only}
    1. Celiker O, Demir G, Kocaoglu M, Altug F, Acar F. Comparison of subthalamic nucleus vs. globus pallidus interna deep brain stimulation in terms of gait and balance; a two year follow-up study. Turkish Neurosurgery 2018;29(3):355-61. - PubMed
Chang 2019 {published data only}
    1. Chang MC, Chun MH. The effect of balance training with Tetra-ataxiometric posturography on balance function in patients with Parkinsonism. Neurorehabilitation 2019;45(3):379-84. - PubMed
Cherup 2019 {published data only}
    1. Cherup NP, Buskard A, Strand L, Roberson KB, Michiels E R, Kuhn JE, et al. Power vs strength training to improve muscular strength, power, balance and functional movement in individuals diagnosed with Parkinson's disease. Experimental Gerontology 2019;128:110740. - PubMed
Chomiak 2017 {published data only}
    1. Chomiak T, Watts A, Meyer N, Pereira FV, Hu B. A training approach to improve stepping automaticity while dual-tasking in Parkinson's disease. Medicine 2017;96(5):e5934. - PMC - PubMed
Chou 2017 {published data only}
    1. Chou KL, Elm JJ, Wielinski CL, Simon DK, Aminoff MJ, Christine CW et, al. Factors associated with falling in early, treated Parkinson's disease: the NET-PD LS1 cohort. Journal of the Neurological Sciences 2017;377:137-43. - PMC - PubMed
Citrome 2018 {published data only}
    1. Citrome L, Norton JC, Chi-Burris K, Demos G. Pimavanserin for the treatment of Parkinson's disease psychosis: number needed to treat, number needed to harm, and likelihood to be helped or harmed. CNS Spectrums 2018;23(3):228-38. - PubMed
Cosentino 2013 {published data only}
    1. Cosentino G, Valentino F, Pozzi NG, Brighina F, Fierro B, Savettieri G, et al. Transcranial direct current stimulation for treatment of freezing of gait in Parkinson's disease. A cross-over study. Journal of the Neurological Sciences 2013;333:e83. - PubMed
Cummings 2013 {published data only}
    1. Cummings J, Isaacson S, Mills R, Williams H, Chi-Burris K, Dhall R, et al. Antipsychotic efficacy and motor tolerability in a phase III placebo-controlled study of pimavanserin in patients with Parkinson's Disease psychosis (Acp-103-020). Journal of the Neurological Sciences 2013;333:e119-20.
da Silva 2019 {published data only}
    1. da Silva LP, Souza Duarte MP, Cassia Batista de Souza C, dos Santos Accioly Lins CC, das Gracas Wanderley de Sales Coriolano M, Lins OG. Effects of mental practice associated with motor physical therapy on gait and risk of falls in Parkinson's disease: a pilot study. Fisioterapia e Pesquisa 2019;26(2):120-7.
Deepa 2019 {published data only}
    1. Deepa S, Ramana K. External cueing on gait parameters in Parkinson's disease. International Journal of Research in Pharmaceutical Sciences 2019;10(3):2452-6.
de Lucena 2017 {published data only}
    1. Lucena Trigueiro LC, Gama GL, Ribeiro TS, Macedo Ferreira LG, Galvao ER, Souza e Silva EM, et al. Influence of treadmill gait training with additional load on motor function, postural instability and history of falls for individuals with Parkinson's disease: A randomized clinical trial. Journal of Bodywork and Movement Therapies 2017;21(1):93-100.. - PubMed
de Natale 2017 {published data only}
    1. Natale ER, Paulus KS, Aiello E, Sanna B, Manca A, Sotgiu G, et al. Dance therapy improves motor and cognitive functions in patients with Parkinson's disease. NeuroRehabilitation 2017;40(1):141-4. - PubMed
Duncan 2018 {published data only}
    1. Duncan RP, Van Dillen LR, Garbutt JM, Earhart GM, Perlmutter JS. Physical therapy and deep brain stimulation in Parkinson's Disease: protocol for a pilot randomized controlled trial. Pilot & Feasibility Studies 2018;4:54. - PMC - PubMed
Elmer 2018 {published data only}
    1. Elmer LW, Juncos JL, Singer C, Truong DD, Criswell SR, Parashos S, et al. Pooled analyses of phase III studies of ADS-5102 (Amantadine) extended-release capsules for dyskinesia in Parkinson's disease. CNS Drugs 2018;32(4):387-98. - PMC - PubMed
El‐Tamawy 2013 {published data only}
    1. El-Tamawy MS, Shehata HS, Shalaby NM, Nawito A, Esmail EH. Can repetitive transcranial magnetic stimulation help on-freezers with Parkinson's disease? Egyptian Journal of Neurology, Psychiatry and Neurosurgery 2013;50(4):355-60.
Emre 2010 {published data only}
    1. Emre M, Tsolaki M, Bonuccelli U, Destee A, Tolosa E, Kutzelnigg A, et al. Memantine for patients with Parkinson's disease dementia or dementia with Lewy bodies: a randomised, double-blind, placebo-controlled trial. Lancet Neurology 2010;9(10):969-77. - PubMed
Galli 2018 {published data only}
    1. Galli M, Vicidomini C, Rozin Kleiner AF, Vacca L, Cimolin V, Condoluci C, et al. Peripheral neurostimulation breaks the shuffling steps patterns in Parkinsonian gait: a double blind randomized longitudinal study with automated mechanical peripheral stimulation. European Journal of Physical & Rehabilitation Medicine. 2018;54(6):860-5. - PubMed
Geroin 2018 {published data only}
    1. Geroin C, Nonnekes J, Vries NM, Strouwen C, Smania N, Tinazzi M, et al. Does dual-task training improve spatiotemporal gait parameters in Parkinson's disease? Parkinsonism & Related Disorders 2018;55:86-91. - PubMed
Giardini 2018 {published data only}
    1. Giardini M, Nardone A, Godi M, Guglielmetti S, Arcolin I, Pisano F, et al. Instrumental or physical-exercise rehabilitation of balance improves both balance and gait in Parkinson's disease. Neural Plasticity 2018;2018:5614242. - PMC - PubMed
Giladi 2013 {published data only}
    1. Giladi N, Boroojerdi B, Surmann E. The safety and tolerability of rotigotine transdermal system over a 6-year period in patients with early-stage Parkinson's disease. Journal of Neural Transmission 2013;120(9):1321-9. - PubMed
Grobbelaar 2017 {published data only}
    1. Grobbelaar R, Venter R, Welman KE. Backward compared to forward over ground gait retraining have additional benefits for gait in individuals with mild to moderate Parkinson's disease: a randomized controlled trial. Gait & Posture 2017;58:294-9. - PubMed
Gu 2013 {published data only}
    1. Gu S, Song Z, Fan X, Chen R, Zheng W, Yan W. Effect of PD-WEBB training on balance impairment and falls in people with Parkinson's disease. [Chinese]. Zhong nan da xue xue bao (Journal of Central South University, Medical sciences) 2013;38(11):1172-6. - PubMed
Gurevich 2007 {published data only}
    1. Gurevich T, Peretz C, Moore O, Weizmann N, Giladi N. The effect of injecting botulinum toxin type a into the calf muscles on freezing of gait in Parkinson's disease: a double blind placebo-controlled pilot study. Movement Disorders 2007;22(6):880-3. - PubMed
Hackney 2007 {published data only}
    1. Hackney ME, Kantorovich S, Earhart GM. A study on the effects of Argentine tango as a form of partnered dance for those with Parkinson Disease and the healthy elderly. American Journal of Dance Therapy 2007;29(2):109-27.
Hauser 2013 {published data only}
    1. Hauser RA, Hsu A, Kell S, Espay AJ, Sethi K, Stacy M, et al. Extended-release carbidopa-levodopa (IPX066) compared with immediate-release carbidopa-levodopa in patients with Parkinson's disease and motor fluctuations: a phase 3 randomised, double-blind trial. Lancet Neurology 2013;12(4):346-56. - PubMed
Hauser 2016 {published and unpublished data}
    1. Francois C, Hauser RA, Aballea S, Dorey J, Kharitonova E, Hewitt LA. Cost-effectiveness of droxidopa in patients with neurogenic orthostatic hypotension: post-hoc economic analysis of Phase 3 clinical trial data. Journal of Medical Economics 2016;19(5):515-25. [PMID: ] - PubMed
    1. Hauser RA, Heritier S, Rowse GJ, Hewitt LA, Isaacson SH. Droxidopa and reduced falls in a trial of Parkinson disease patients with neurogenic orthostatic hypotension. Clinical Neuropharmacology 2016;39(5):220-6. [PMID: ] - PMC - PubMed
    1. Hauser RA, Hewitt LA, Isaacson S. Droxidopa in patients with neurogenic orthostatic hypotension associated with Parkinson's disease (NOH306A). Journal of Parkinson's Disease 2014;4(1):57-65. [PMID: ] - PubMed
    1. Hauser RA, Isaacson S, Lisk JP, Hewitt LA, Rowse G. Droxidopa for the short-term treatment of symptomatic neurogenic orthostatic hypotension in Parkinson's disease (nOH206B). Movement Disorders 2015;30(5):646-54. [PMID: ] - PubMed
Hawkins 2018 {published data only}
    1. Hawkins B L, Van Puymbroeck M, Walter A, Sharp J, Woshkolup K, Urrea-Mendoza E, et al. Perceived activities and participation outcomes of a yoga intervention for individuals with Parkinson's disease: a mixed methods study. International Journal of Yoga Therapy 2018;28(1):51-61. - PubMed
Hewitt 2018 {published data only}
    1. Hewitt J, Goodall S, Clemson L, Henwood T, Refshauge K. Progressive resistance and balance training for falls prevention in long-term residential aged care: a cluster randomized trial of the Sunbeam Program. Journal of the American Medical Directors Association 2018;19(4):361-9. - PubMed
Hill 2015 {published data only (unpublished sought but not used)}
    1. Hill A, McPhail SM, Waldron N, Etherton-Beer C, Ingram K, Flicker L, et al. Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial. Lancet 2015;385:2592-9. [PMID: ] - PubMed
    1. Hill A, Waldron N, Etherton-Beer C, McPhail SM, Ingram K, Flicker L, et al. A stepped-wedge cluster randomised controlled trial for evaluating rates of falls among inpatients in aged care rehabilitation units receiving tailored multimedia education in addition to usual care: a trial protocol. BMJ Open 2014;4(1):e004195. [PMID: ] - PMC - PubMed
Hiller 2018 {published data only}
    1. Hiller AL, Murchison CF, Lobb BM, O'Connor S, O'Connor M, Quinn J F. A randomized, controlled pilot study of the effects of vitamin D supplementation on balance in Parkinson's disease: does age matter? PLOS One [Electronic Resource] 2018;13(9):e0203637. - PMC - PubMed
Hubble 2018 {published data only}
    1. Hubble RP, Naughton G, Silburn PA, Cole MH. Trunk exercises improve gait symmetry in Parkinson disease: a blind phase ii randomized controlled trial. American Journal of Physical Medicine & Rehabilitation 2018;97(3):151-9. - PubMed
Hubble 2019 {published data only}
    1. Hubble RP, Silburn PA, Naughton GA, Cole MH. Trunk exercises improve balance in Parkinson disease: a phase II randomized controlled yrial. Journal of Neurologic Physical Therapy 2019;43(2):96-105. - PubMed
Kalyani 2020 {published data only}
    1. Kalyani HH, Sullivan KA, Moyle GM, Brauer S, Jeffrey ER, Kerr GK. Dance improves symptoms, functional mobility and fine manual dexterity in people with Parkinson disease: a quasi-experimental controlled efficacy study. European Journal of Physical & Rehabilitation Medicine 2020;08:08. - PubMed
Kanegusuku 2017 {published data only}
    1. Kanegusuku H, Silva-Batista C, Pecanha T, Nieuwboer A, Silva ND Jr, Costa LA, et al. Effects of progressive resistance training on cardiovascular autonomic regulation in patients with Parkinson's disease: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation 2017;98(11):2134-41. - PubMed
Klamroth 2019 {published data only}
    1. Klamroth S, Gasner H, Winkler J, Eskofier B, Klucken J, Pfeifer K, et al. Interindividual balance adaptations in response to perturbation treadmill training in persons with Parkinson disease. Journal of Neurologic Physical Therapy 2019;43(4):224-32. - PubMed
Kurlan 2015 {published data only (unpublished sought but not used)}
    1. Kurlan R, Evans R, Wrigley S, McPartland S, Bustami R, Cotter A. Tai Chi in Parkinson's disease: a preliminary randomized, controlled, and rater-blinded study. Advances in Parkinson's Disease 2015;4:9-12.
Lang 2016 {published data only}
    1. Lang AE, Rodriguez RL, Boyd JT, Chouinard S, Zadikoff C, Espay AJ, et al. Integrated safety of levodopa-carbidopa intestinal gel from prospective clinical trials. Movement Disorders 2016;31(4):538-46. - PMC - PubMed
Lees 2017 {published data only}
    1. Lees AJ, Ferreira J, Rascol O, Reichmann H, Stocchi F, Tolosa E, et al. Opicapone for the management of end-of-dose motor fluctuations in patients with Parkinson's disease treated with L-DOPA. Expert Review of Neurotherapeutics 2017;17(7):649-59. - PubMed
LeWitt 2019 {published data only}
    1. LeWitt PA, Hauser RA, Pahwa R, Isaacson SH, Fernandez HH, Lew M, et al. Safety and efficacy of CVT-301 (levodopa inhalation powder) on motor function during off periods in patients with Parkinson's disease: a randomised, double-blind, placebo-controlled phase 3 trial. The Lancet Neurology 2019;18(2):145-54. - PubMed
Li 2019 {published data only}
    1. Li Z, Zhuang J, Jiang Y, Xiao G, Jie K, Wang T, et al. Study protocol for a single-blind randomised controlled trial to evaluate the clinical effects of an Integrated Qigong exercise intervention on freezing of gait in Parkinson's disease. BMJ Open 2019;9(9):e028869. - PMC - PubMed
Lieberman 2019 {published data only}
    1. Lieberman A, Lockhart TE, Olson MC, Smith Hussain VA, Frames CW, Sadreddin A, et al. Nicotine Bitartrate reduces falls and freezing of gait in Parkinson disease: a reanalysis. Frontiers in Neurology 2019;10:424. - PMC - PubMed
Litvinenko 2007 {published data only}
    1. Litvinenko IV, Odinak MM, Mogilnaya VI, Yu Emelin A. Efficacy and safety of galantamine (reminyl) in the treatment of dementia in patients with Parkinson's disease (open-label controlled trial). [Russian]. Zhurnal Nevrologii i Psihiatrii imeni S.S 2007;107(12):25-33. - PubMed
Litvinenko 2008 {published data only}
    1. Litvinenko IV, Odinak MM, Mogil'naya V I, Emelin AY. Efficacy and safety of galantamine (reminyl) for dementia in patients with Parkinson's disease (an open controlled trial). Neuroscience and Behavioral Physiology 2008;38(9):937-45. - PubMed
Mancini 2019 {published data only}
    1. Mancini M, Chung K, Zajack A, Martini DN, Ramsey K, Lapidus J, et al. Effects of augmenting cholinergic neurotransmission on balance in Parkinson's disease. Parkinsonism & Related Disorders 2019;69:40-7. - PubMed
Marumoto 2019 {published data only}
    1. Marumoto K, Yokoyama K, Inoue T, Yamamoto H, Kawami Y, Nakatani A, et al. Inpatient enhanced multidisciplinary care effects on the quality of life for Parkinson disease: a quasi-randomized controlled trial. Journal of Geriatric Psychiatry and Neurology 2019;32(4):186-94. - PMC - PubMed
McDonald 2018 {published data only}
    1. McDonald J, Pourcher E, Nadeau A, Corbeil P. A randomized trial of oral and transdermal rivastigmine for postural instability in Parkinson disease dementia. Clinical Neuropharmacology 2018;41(3):87-93. - PubMed
Mezzarobba 2018 {published data only}
    1. Mezzarobba S, Grassi M, Pellegrini L, Catalan M, Kruger B, Furlanis G, et al. Action observation plus sonification. A novel therapeutic protocol for Parkinson's patient with freezing of gait. Frontiers in Neurology 2018;8(Jan):723. - PMC - PubMed
Mi 2019 {published data only}
    1. Mi TM, Garg S, Ba F, Liu AP, Wu T, Gao LL, et al. High-frequency rTMS over the supplementary motor area improves freezing of gait in Parkinson's disease: a randomized controlled trial. Parkinsonism & Related Disorders 2019;68:85-90. - PubMed
Miller 2019 {published data only}
    1. Miller Koop M, Rosenfeldt AB, Alberts JL. Mobility improves after high intensity aerobic exercise in individuals with Parkinson's disease. Journal of the Neurological Sciences 2019;399:187-93. - PubMed
Moro 2010 {published data only}
    1. Moro E, Hamani C, Poon YY, Al-Khairallah T, Dostrovsky JO, Hutchison WD, et al. Unilateral pedunculopontine stimulation improves falls in Parkinson's disease. Brain 2010;133(1):215-24. - PubMed
Myers 2019 {published data only}
    1. Myers PS, Harrison EC, Rawson KS, Horin AP, Sutter EN, McNeely ME, et al. Yoga Improves balance and low-back pain, but not anxiety, in people with Parkinson's disease. International Journal of Yoga Therapy 2019;04:04. - PMC - PubMed
Negrini 2017 {published data only}
    1. Negrini S, Bissolotti L, Ferraris A, Noro F, Bishop M, Villafane J H. Nintendo Wii Fit for balance rehabilitation in patients with Parkinson's disease: a comparative study. Journal of Bodywork and Movement Therapies 2017;21(1):117-23. - PubMed
Nieuwboer 2007 {published data only}
    1. Nieuwboer A, Kwakkel G, Rochester L, Jones D, Wegen E, Willems AM, et al. Cueing training in the home improves gait-related mobility in Parkinsons disease: the RESCUE trial. Journal of Neurology, Neurosurgery and Psychiatry 2007;78(2):134-40.. - PMC - PubMed
Oertel 2013 {published data only}
    1. Oertel W, LeWitt P, Giladi N, Ghys L, Grieger F, Boroojerdi B. Treatment of patients with early and advanced Parkinson's disease with rotigotine transdermal system: age-relationship to safety and tolerability. Parkinsonism & Related Disorders 2013;19(1):37-42. - PubMed
Okun 2012 {published data only}
    1. Okun MS, Gallo BV, Mandybur G, Jagid J, Foote KD, Revilla FJ, et al. Subthalamic deep brain stimulation with a constant-current device in Parkinson's disease: an open-label randomised controlled trial. Lancet Neurology. 2012;11:140-9. - PubMed
Olanow 2020 {published data only}
    1. Olanow CW, Factor SA, Espay AJ, Hauser RA, Shill HA, Isaacson S, et al. Apomorphine sublingual film for off episodes in Parkinson's disease: a randomised, double-blind, placebo-controlled phase 3 study. Lancet Neurology 2020;19(2):135-44. - PubMed
Ozgonenel 2016 {published data only}
    1. Ozgonenel L, Cagirici S, Cabalar M, Durmusoglu G. Use of game console for rehabilitation of Parkinson's disease. Balkan Medical Journal 2016;33(4):396-400. - PMC - PubMed
Perez 2017 {published data only}
    1. Perez de la Cruz S. Effectiveness of aquatic therapy for the control of pain and increased functionality in people with Parkinson's disease: a randomized clinical trial. European Journal of Physical & Rehabilitation Medicine. 2017;53(6):825-32. - PubMed
Pohl 2020 {published data only}
    1. Pohl P, Wressle E, Lundin F, Enthoven P, Dizdar N. Group-based music intervention in Parkinson's disease - findings from a mixed-methods study. Clinical Rehabilitation 2020;34(4):533-44. - PMC - PubMed
Postuma 2008 {published data only}
    1. Postuma RB, Gagnon JF, Vendette M, Charland K, Montplaisir J. REM sleep behaviour disorder in Parkinson's disease is associated with specific motor features. Journal of Neurology, Neurosurgery & Psychiatry 2008;79(10):1117-21. - PubMed
Rascol 2016 {published data only}
    1. Rascol O, Hauser RA, Stocchi F, Fitzer-Attas CJ, Sidi Y, Abler V, et al. Long-term effects of rasagiline and the natural history of treated Parkinson's disease. Movement Disorders 2016;31(10):1489-96. - PubMed
Rawson 2019 {published data only}
    1. Rawson KS, McNeely ME, Duncan RP, Pickett KA, Perlmutter JS, Earhart GM. Exercise and Parkinson disease: comparing tango, treadmill, and stretching. Journal of Neurologic Physical Therapy 2019;43(1):26-32. - PMC - PubMed
Sato 2011 {published data only}
    1. Sato Y, Iwamoto J, Honda Y. Amelioration of osteoperosis and hypovitaminosis D by sunlight exposure in Parkinson's disease. Parkinsonism and Related Disorders 2011;17(1):22-6. - PubMed
Sato 2013 {published data only}
    1. Sato Y, Iwamoto J, Honda Y, Amano N. Vitamin D reduces falls and hip fractures in vascular Parkinsonism but not in Parkinson's disease. Therapeutics and Clinical Risk Management 2013;9(1):171-6. - PMC - PubMed
Schenkman 2018 {published data only}
    1. Schenkman M, Moore CG, Kohrt WM, Hall DA, Delitto A, Comella CL, et al. Effect of high-intensity treadmill exercise on motor symptoms in patients with De Novo Parkinson disease a phase 2 randomized clinical trial. JAMA Neurology 2018;75(2):219-26. - PMC - PubMed
Scianni 2015 {published data only}
    1. Scianni A. Tai Chi improves balance and prevents falls in people with Parkinson's disease. Journal of Physiotherapy 2015;61(1):44. - PubMed
Sedaghati 2018 {published data only}
    1. Sedaghati P, Goudarzian M, Daneshmandi H, Ardjmand A. Effects of alexander-based corrective techniques on forward flexed posture, risk of fall, and fear of falling in idiopathic Parkinson's disease. Archives of Neuroscience 2018;5(2):e61274.
Silva‐Batista 2018 {published data only}
    1. Silva-Batista C, Corcos DM, Kanegusuku H, Piemonte ME, Gobbi LT, Lima-Pardini AC, et al. Balance and fear of falling in subjects with Parkinson's disease is improved after exercises with motor complexity. Gait & Posture 2018;61:90-7. - PubMed
Simuni 2020 {published data only}
    1. Simuni T. Isradipine versus placebo in early Parkinson disease a randomized trial. Annals of Internal Medicine 2020;172(9):591-8. - PMC - PubMed
Sparrow 2016 {published data only (unpublished sought but not used)}
    1. Saprrow D, DeAngelis TR, Hendron K, Thomas CA, Saint-Hilaire S, Ellis T. Highly challenging balance program reduces fall rate in Parkinson disease. Journal of Neurologic Physical Therapy 2016;40(1):24-30. [PMID: ] - PMC - PubMed
St George 2015 {published data only}
    1. St George RJ, Carlson-Kuhta P, King LA, Burchiel KJ, Horak FB. Compensatory stepping in Parkinson's disease is still a problem after deep brain stimulation randomized to STN or GPi. Journal of Neurophysiology 2015;114(3):1417-23. - PMC - PubMed
Stozek 2003 {published data only}
    1. Stozek J, Rudzinska M, Longawa K, Szczudlik A. The effect of the complex rehabilitation on posture and gait in Parkinson disease. [Polish]. Neurologia i Neurochirurgia Polska 2003;37 Suppl 5:67-81. - PubMed
Strouwen 2017 {published data only}
    1. Strouwen C, Molenaar Ealm Munks L, Keus SH, Zijlmans JC, Vandenberghe W, Bloem BR, et al. Training dual tasks together or apart in Parkinson's disease: results from the DUALITY trial. Movement Disorders 2017;32(8):1201-10. - PubMed
Thevathasan 2010 {published data only}
    1. Thevathasan W, Silburn PA, Brooker H, Coyne TJ, Khan S, Gill SS, et al. The impact of low-frequency stimulation of the pedunculopontine nucleus region on reaction time in parkinsonism. Journal of Neurology, Neurosurgery and Psychiatry 2010;81(10):1099-104. - PubMed
Toole 2005 {published data only}
    1. Toole T, Maitland CG, Warren E, Hubmann MF, Panton L. The effects of loading and unloading treadmill walking on balance, gait, fall risk, and daily function in Parkinsonism. NeuroRehabilitation 2005;20(4):307-22. - PubMed
van Nimwegen 2013 {published data only}
    1. Nimwegen M, Speelman AD, Overeem S, de Warrenburg BP, Smulders K, Dontje ML, et al. Promotion of physical activity and fitness in sedentary patients with Parkinson's disease: randomised controlled trial. BMJ 2013;346:f576. - PMC - PubMed
Van Puymbroeck 2018 {published data only}
    1. Van Puymbroeck M, Walter AA, Hawkins BL, Sharp JL, Woschkolup K, Urrea-Mendoza E, et al. Functional improvements in Parkinson's disease following a randomized trial of yoga. Evidence-Based Complementary & Alternative Medicine: eCAM 2018;2018:8516351. - PMC - PubMed
Vercruysse 2014 {published data only}
    1. Vercruysse S, Vandenberghe W, Munks L, Nuttin B, Devos H, Nieuwboer A. Effects of deep brain stimulation of the subthalamic nucleus on freezing of gait in Parkinson's disease: a prospective controlled study. Journal of Neurology, Neurosurgery and Psychiatry 2014;85(8):872-8. - PubMed
Walter 2019 {published data only}
    1. Walter AA, Adams EV, Van Puymbroeck M, Crowe BM, Urrea-Mendoza E, Hawkins BL, et al. Changes in nonmotor symptoms following an 8-week yoga intervention for people with Parkinson’s disease. International Journal of Yoga Therapy 2019;29(1):91-9. - PubMed
Wass 2008 {published data only}
    1. Wass S, Webster PJ, Nair BR. Delirium in the elderly: a review. Oman Medical Journal 2008;23(3):150-7. - PMC - PubMed
Welter 2015 {published data only}
    1. Welter ML, Demain A, Ewenczyk C, Czernecki V, Lau B, El Helou A, et al. PPNa-DBS for gait and balance disorders in Parkinson's disease: a double-blind, randomised study. Journal of Neurology 2015;262(6):1515-25. - PubMed
Whone 2019 {published data only}
    1. Whone A, Luz M, Boca M, Woolley M, Mooney L, Dharia S, et al. Randomized trial of intermittent intraputamenal glial cell line-derived neurotrophic factor in Parkinson's disease. Brain 2019;142(3):512-25. - PMC - PubMed
Wong 2016 {published data only}
    1. Wong RK, Tsang DS, Lau CK, Chan AY, Chan DT, Zhu X, et al. Effectiveness of occupational therapy multi-domain group therapy program for Parkinson's disease. Movement Disorders 2016;31:S159.
Yuan 2020 {published data only}
    1. Yuan RY, Chen SC, Peng CW, Lin YN, Chang YT, Lai CH. Effects of interactive video-game-based exercise on balance in older adults with mild-to-moderate Parkinson's disease. Journal of Neuroengineering & Rehabilitation 2020;17(1):91. - PMC - PubMed
Zhang 2018 {published data only}
    1. Zhang Z, Shao M, Chen S, Liu C, Peng R, Li Y, et al. Adjunct rasagiline to treat Parkinson's disease with motor fluctuations: a randomized, double-blind study in China. Translational Neurodegeneration 2018;7(1):14. - PMC - PubMed

References to studies awaiting assessment

Lurie 2020 {published and unpublished data}
    1. Lurie JD, Zagaria AB, Ellis L, Pidgeon D, Gill-Body KM, Burke C, et al. Surface perturbation training to prevent falls in older adults: a highly pragmatic, randomized controlled trial. Physical Therapy 2020;100(7):1153-62. [PMID: ] - PMC - PubMed
Taylor 2021 {published data only}
    1. Taylor PN, Sampson T, Beare B, Donavon-Hall M, Thomas PW, Marques E, et al. The effectiveness of peroneal nerve functional electrical stimulation for the reduction in bradykinesia in Parkinson's disease: a feasibility study for a randomised control trial. Clinical Rehabilitation 2021;35(4):546-57. [PMID: ] - PubMed

References to ongoing studies

ACTRN12618001515280 {published data only}
    1. ACTRN12618001515280. SAFE-PD - Stepping to Avoid Fall Events in Parkinson’s disease. https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001... (first receieved september 10, 2018).
ACTRN12619000415101 {published data only}
    1. ACTRN12619000415101. The Integrate program for safe mobility in Parkinson's disease.. https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12619000... (first received March 13, 2019).
ACTRN12620001135909 {published data only}
    1. ACTRN12620001135909. A randomised trial of exercise therapy for Parkinson’s disease. https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12620001135909 (first received October 30, 2020).
ChiCTR2000038852 {published data only}
    1. ChiCTR2000038852. Study on the effect and mechanism of cognitive-cup-tapping-balance-training on fall prevention in community Parkinson's patients: a randomized controlled trial. https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR2000038852 (first received October 7, 2020).
DRKS00024982 {published data only}
    1. DRKS00024982. Effects of an activity-oriented physiotherapy exercise programme with and without eye movement training on dynamic balance and fall risk in people with Parkinson’s disease: a randomised controlled pilot trial. https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00024982 (first received April 8, 2021).
NCT02107638 {published data only}
    1. NCT02107638. Effect of osteopathic manipulative medicine on Parkinson disease. https://clinicaltrials.gov/ct2/show/NCT02107638 (first receieved April 8, 2014).
NCT03727529 {published data only}
    1. NCT03727529. Immersive virtual reality to improve Gait in Parkinson's disease (NMSK-LH02). https://clinicaltrials.gov/ct2/show/NCT03727529 (first receieved November 1, 2018).
NCT03751371 {published data only}
    1. NCT03751371. Robotic walking device to improve mobility in Parkinson's disease. https://clinicaltrials.gov/ct2/show/NCT03751371 (first receieved November 23, 2018).
NCT03972969 {published data only}
    1. NCT03972969. Highly challenging balance program to reduce fall rate in PD. https://clinicaltrials.gov/ct2/show/NCT03972969 (first receieved June 4, 2019).
NCT04093544 {published data only}
    1. NCT04093544. Expanding the therapeutic window of deep brain stimulation in Parkinson's disease by means of directional leads. https://clinicaltrials.gov/ct2/show/NCT04093544 (first receieved September 8, 2019).
NCT04108741 {published data only}
    1. NCT04108741. Augmented reality treadmill training in patients with Parkinson's disease (Falls in PD). https://clinicaltrials.gov/ct2/show/NCT04108741 (first receieved september 30, 2019).
NCT04116177 {published data only}
    1. NCT04116177. Flexible vs. standard deep brain stimulation programming in Parkinson disease patients. https://clinicaltrials.gov/ct2/show/NCT04116177 (first receieved October 4, 2019).
NCT04226248 {published data only}
    1. NCT04226248. CHIEF PD (CHolinesterase Inhibitor to prEvent Falls in Parkinson's Disease). https://clinicaltrials.gov/ct2/show/NCT04226248 (first receieved January 13, 2020).
NCT04300023 {published data only}
    1. NCT04300023. In-home cycling for individuals with PD. https://clinicaltrials.gov/ct2/show/NCT04300023 (first receieved March 9, 2020).
NCT04300348 {published data only}
    1. NCT04300348. Improving walking with Heel-To-Toe device. https://clinicaltrials.gov/ct2/show/NCT04300348 (first received March 9, 2020).
NCT04389138 {published data only}
    1. NCT04389138. Is physiotherapy effective for people with early Parkinson's (PEEP). https://clinicaltrials.gov/ct2/show/NCT04389138 (first receieved May 15, 2020).
NCT04408573 {published data only}
    1. NCT04408573. Cycling deep brain stimulation on Parkinson's disease gait (DBS). https://clinicaltrials.gov/ct2/show/NCT04408573 (first receieved May 29, 2020).
NCT04555720 {published data only}
    1. NCT04555720. The Benchmark Clinic: an interdisciplinary comprehensive care model for people with Parkinson disease. https://clinicaltrials.gov/ct2/show/NCT04555720 (first received September 21, 2020).
NCT04613141 {published data only}
    1. NCT04613141. The WalkingTall Study: comparing WalkingTall with Parkinson's Disease (WalkingTall-PD) with mobility-plus to reduce falls and improve mobility. (WalkingTall-PD). https://clinicaltrials.gov/ct2/show/NCT04613141 (first received November 3, 2020).
NCT04634331 {published data only}
    1. NCT04634331. Dual-task Augmented Reality Treatment for Parkinson's disease (DART). https://clinicaltrials.gov/ct2/show/NCT04634331 (first received November 18, 2020).
NCT04665869 {published data only}
    1. NCT04665869. Long-term effects of combined balance and brisk walking in Parkinson's disease. https://clinicaltrials.gov/ct2/show/NCT04665869 (first received December 14, 2020).
NCT04694443 {published data only}
    1. NCT04694443. Multidisciplinary home-based Tele-rehabilitation Intervention (TeleFall). https://clinicaltrials.gov/ct2/show/NCT04694443 (first received January 5, 2021).
NCT04848077 {published data only}
    1. NCT04848077. STEPWISE Parkinson: a Smartphone based exercise solution for patients with Parkinson's disease (STEPWISE). https://clinicaltrials.gov/ct2/show/NCT04848077 (first received April 19, 2021).
NCT04874051 {published data only}
    1. NCT04874051. Sensor-based assessment and rehabilitation of balance in neurological diseases (BALANCE). https://clinicaltrials.gov/ct2/show/NCT04874051 (first received May 5, 2021).
NCT04897256 {published data only}
    1. NCT04897256. Mobility in daily life and falls in Parkinson's disease: potential for rehabilitation. https://clinicaltrials.gov/ct2/show/NCT04897256 (first received May 21, 2021).
NCT04946812 {published data only}
    1. NCT04946812. Split-belt treadmill training to rehabilitate freezing of gait and balance in Parkinson's disease. https://clinicaltrials.gov/ct2/show/NCT04946812 (first received July 1, 2021).
NCT04953637 {published data only}
    1. NCT04953637. Physiotherapy and deep brain stimulation in Parkinson's disease. https://clinicaltrials.gov/ct2/show/NCT04953637 (first received July 8, 2021).
NCT05127057 {published data only}
    1. NCT05127057. Proactive and Integrated Management and Empowerment in Parkinson's disease (PRIME-UK): a New model of care (PRIME-RCT) (PRIME-RCT). https://clinicaltrials.gov/ct2/show/NCT05127057 (first received November 19, 2021).
NCT05172661 {published data only}
    1. NCT05172661. Effects of physical-cognitive training with different task models in Parkinson's disease with mild cognitive impairment. https://clinicaltrials.gov/ct2/show/NCT05172661 (first received December 29, 2021).
RBR‐5w2sqt {published data only}
    1. RBR-5w2sqt. Effects of strength exercises with elastic bands and tubes on the difficulty of movements, quality of life, sleep, memory, depressive symptoms, balance and risk of falls of patients with Parkinson's disease. http://www.ensaiosclinicos.gov.br/rg/RBR-5w2sqt/ (first receieved february 24, 2020).

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