# Highly challenging balance program to reduce fall rate in PD

> **NIH VA I01** · VA BOSTON HEALTH CARE SYSTEM · 2021 · —

## Abstract

Project Background/Rationale. Parkinson’s disease (PD) is the second most common neurodegenerative
disease, affecting over one million Americans. The cardinal clinical manifestations of PD include resting tremor,
rigidity, bradykinesia, and postural instability/gait disturbance (Olanow et al., 2009). In addition, people with
PD fall frequently, with 60% falling annually and two-thirds of these falling recurrently (Latt et al., 2009; Allen et
al., 2013; Bloem et al., 2001). Identifying interventions that successfully improve postural control and reduce
fall rate is critical to reduce disability, improve quality of life, and potentially increase survival in patients with
PD. Recent randomized, controlled trials (RCT) have examined the effects of exercise and physical therapy
interventions on reducing falls in patients with PD; however, with mixed results.
Project Objectives. There is a limited availability of effective treatment options to reduce falls in PD. In this
context, evidence from two meta-analyses (Sherrington et al., 2017; Allen et al., 2011) indicates that highly
challenging exercise approaches may lead to better outcomes. We propose investigating the effects of two
theoretically driven, progressive, highly challenging exercise programs: 1) a facility-based in-person exercise
program that demonstrated a significant decline in fall rate over time in a small sample of patients (Sparrow et
al., 2016) and 2) a novel home-based program centered around remote, real-time exercise instruction and
supervision via regular videoconferencing. Both programs will be delivered by a physical therapist with
experience treating patients with PD. There will also be a control group in which health education is provided.
Project Methods. We propose to conduct an RCT evaluating effects on fall rate, dynamic balance, and fear of
falling. A total of 162 VA patients with mild-to-moderate PD will be randomly assigned to one of the three 3-
month interventions: in-person exercise at the VA, remotely-delivered exercise, or health education. Outcomes
will be compared between each intervention group and the control group. The primary outcome will be the fall
rate. Fall rates will be compared between groups with the use of negative binomial regression models.

## Key facts

- **NIH application ID:** 10201779
- **Project number:** 5I01RX003055-03
- **Recipient organization:** VA BOSTON HEALTH CARE SYSTEM
- **Principal Investigator:** DAVID W. SPARROW
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10201779

## Citation

> US National Institutes of Health, RePORTER application 10201779, Highly challenging balance program to reduce fall rate in PD (5I01RX003055-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10201779. Licensed CC0.

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