Tertiary Prevention in Parkinson Disease

Background and Purpose: The purpose of this study was twofold: (1) to summarize literature related to postural instability, balance assessment, and exercise programs for people with Parkinson Disease (PD); and (2) to present findings from a preliminary study investigating the effects of a tertiary prevention group exercise program on balance in people with PD. Subjects: Eight subjects with PD completed the study. Methods: Subjects were measured on the functional reach test, the single limb stance duration test, and the Expanded Timed Up and Go test (ETUG) before and after a 6-week tertiary prevention program. The experimental group participated in a 6-week group wellness program that included balance, gait, strengthening, and flexibility exercises, while those in the comparison group participated in social support group meetings. Results: There was a high attrition rate of subjects during this preliminary study. There were no significant differences in functional reach, single limb stance duration, total ETUG score, or any component of the ETUG between the two groups at the pretest or posttest, and neither group showed improvements in balance over the 6 weeks of therapy. Conclusion and Discussion: A 6-week tertiary prevention exercise program for people with PD was not shown to enhance balance, although some subjects and their families described subjective reports of improvement. Attrition may be a factor limiting the success of tertiary prevention programs. This pilot study can serve as a stimulus for future research and discussion regarding tertiary prevention programs.