Balance and falls in Parkinson's disease: A meta-analysis of the effect of exercise and motor training

This systematic review with meta‐analysis aimed to determine the effects of exercise and motor training on the performance of balance‐related activities and falls in people with Parkinson's disease. Sixteen randomized and quasi‐randomized controlled trials that assessed the efficacy of exercise and/or motor training against no intervention or placebo intervention were included. The primary outcome measures were balance‐related activity performance (15 trials) and falls (2 trials). The pooled estimate of the effect of exercise and motor training indicated significantly improved balance‐related activity performance (Hedges' g, 0.33; 95% confidence interval, 0.11–0.55; P = .003), but there was no evidence of an effect on the proportion of fallers (risk ratio, 1.02; 95% confidence interval, 0.66–1.58, P = .94). Balance‐related activity performance improved to a greater extent in the trials of programs involving highly challenging balance training, but the difference in effect sizes was not statistically significant (P = .166). Exercise and motor training can improve the performance of balance‐related activities in people with Parkinson's disease. However, further research is required to determine if falls can be prevented in this population. © 2011 Movement Disorder Society