Interventions aimed at lowering risk of falling at home in Parkinson's disease: a literature review

Abstract

Background Falls are the most frequent domestic accidents and their impact on subjects' quality of life, healthcare system and potentially serious complications, make their prevention fundamental. 80% of patients with Parkinson's disease fall in their homes, therefore the prevention of falls becomes a priority in caring for these patients. The aim of the study is to identify the evidence relating to home falls prevention interventions in patients with Parkinson's disease. Methods A literature review was performed considering articles published between 2000 and 2017 and indexed in PubMed, Cinhal and Cochrane Library. 655 articles were identified and 28 selected and considered for review. Results Four macro types of intervention have been identified: environmental and educational interventions, through the preparation of aids, lighting systems, room adaptation, adequate footwear and involvement of caregivers; physical and rehabilitative interventions, through programs of Qigong Baduanjin, Hi-Balance, Tai-Chi, Ai-Chi, vestibular rehabilitation and exercises marked by the metronome; pharmacological interventions, through a continuous infusion system of Rivastigmine or Levodopa; alternative therapies such as vitamin C and Macuna Pruriens. Conclusions The available literature points out the effectiveness of multiple interventions in reducing the risk of falling at home for Parkinson's disease patients. To ensure these interventions, a multidisciplinary team management is needed. This approach allows an improvement in the management of the Parkinsonian patient, promoting the maintenance of health and quality of life, preventing complications and optimizing subject's residual abilities and promoting caregivers' involvement. Key messages The literature points out the effectiveness of multiple interventions in reducing the risk of falling at home for Parkinson's disease patients. Four macro types of intervention have been identified: environmental and educational, physical and rehabilitative interventions, pharmacological and alternative therapies.