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A multi-centre, randomised controlled trial of the effectiveness of PDSAFE to prevent falls among people with Parkinson's: study protocol

Lookup NU author(s): Professor Lynn RochesterORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Background: Falls amongst people with Parkinson's (PwP) result in significant disability and reduced quality of life. There is emerging evidence that exercise-based and physiotherapeutic interventions are of benefit for improving fall risk factors, such as balance. However, the benefit, in terms of preventing falls, is mixed. The development of effective interventions has been identified as the highest research priority for this population.The aim of this trial is to establish the effectiveness and cost-effectiveness of a novel, home-based physiotherapy programme, compared with usual care, on falls amongst PwP.Methods/Design: A UK multi-centre, community-based, single blind, randomised controlled trial with twelve month follow-up, and nested economic evaluation and qualitative studies will be undertaken. Six hundred PwP who live in their own home, have had one or more falls in the previous year and an MMSE score of >= 24 will be recruited.Those living in care homes and those needing assistance from another person to walk indoors will not be eligible. The intervention is a physiotherapist delivered, individually tailored and progressive, home-based programme (PDSAFE) comprising task orientated movement strategy training, functional lower limb strengthening and balance training, of six months duration. Unsupervised daily home exercises and strategies will be practised and supported using technology. Control participants will receive usual care.Data collection will include falls, cognitive state, balance and mobility, fear of falling, freezing of gait, mood, quality of life, carer quality of life and resource use. Data will be collected at baseline, three, six and twelve months. Longitudinal semi-structured interviews will be undertaken with forty participants to explore the expectations and experiences of participants.The primary outcome is risk of repeat falling at six months post-randomisation.Discussion: The aims of this trial are to establish the effectiveness and cost-effectiveness of a novel, home-delivered physiotherapy intervention (PDSAFE) compared with usual care on risk of falling for PwP who have a history of falling. PDSAFE is a novel intervention that builds upon the existing literature and targeting known risk factors, being the first study that uses a novel delivery modus (technology) in conjunction with traditional physiotherapeutic approaches.


Publication metadata

Author(s): Goodwin VA, Pickering R, Ballinger C, Roberts H, McIntosh E, Lamb S, Nieuwboer A, Rochester L, Ashburn A, PDSAFE Protocol Dev Grp

Publication type: Article

Publication status: Published

Journal: BMC Neurology

Year: 2015

Volume: 15

Online publication date: 15/05/2015

Acceptance date: 30/04/2015

Date deposited: 20/04/2016

ISSN (electronic): 1471-2377

Publisher: BioMed Central

URL: http://dx.doi.org/10.1186/s12883-015-0332-2

DOI: 10.1186/s12883-015-0332-2


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Funding

Funder referenceFunder name
CLAHRC Oxford
CLAHRC Wessex
National Institute for Health Research (NIHR) Collaboration for Applied Health Research and Care (CLAHRC) South West Peninsula
10/57/21National Institute for Health Research HTA programme

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