Effects of Physical Exercise on Risk of Fall in People with Parkinson's: A Systematic Review
Keywords:
physical exercise, risk of falls, Parkinson's disease, physical therapy, rehabilitationAbstract
Introduction: Parkinson's disease (PD) is a progressive and neurodegenerative disorder that mainly affects the motor system, with symptoms associated with rigidity, tremors, bradykinesia, postural instability and balance dysfunction. Objective: Analyze physical exercise programs, their modalities and loads, used as complementary treatment, in order to analyze their effects on the risk of falling in patients with Parkinson's disease. Methodology: A systematic review was carried out according to the PRISMA Guidelines. The research was aimed at detecting RCTs in the Epistemonikos database, which includes records from Pubmed, Cochrane, EMBASE, among others. Studies were included that applied physical exercise programs in patients with PD, and that report the determination of the risk of falling using specific instruments for this. Results: 10 trials met the inclusion criteria and were considered for analysis. Physical exercise modalities consisted of progressive strength, balance, muscle power, and step training. In addition to training movement strategies to avoid falls, reduce freezing of gait, and also aquatic physiotherapy. Only one trial reported significant improvements for the two variables associated with risk of falls: hydrotherapy training with balance training, which reported positive results in rate of falls (p = 0.001) and fear of falling (p = 0.003). Conclusions: This study has shown that some modalities of interventions can reduce the risk of falls, therefore, physical exercise must be considered as a fundamental non-pharmacological treatment to combat the factors associated with PD. Strength training is the most widely used and, at the same time, it is suggested that in-water balance therapy obtains more effective results in terms of reducing the risk of falls, and the fear of falling.
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