Cochrane · systematic review · CD011574
Interventions for preventing falls in Parkinson's disease
Allen, NE, Canning, CG, Almeida, LRS, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
Movement DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
24
current version
GRADE rated
18
No studies
6
Included studies
NR
No studies 6 · 25%Ungraded 0 · 0%Very low 12 · 50%Low 4 · 16.7%Moderate 2 · 8.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings for exercise compared to control
Population: People with Parkinson's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of Falls (falls per person‐year) Summary of findings for exercise vs control | Rate ratio 0.74 [0.63, 0.87] | 12 studies · 1456 participants | Moderate Downgraded: risk of bias, indirectness |
Number of people who experienced one or more falls Summary of findings for exercise vs control | Risk ratio 0.9 [0.8, 1] | 9 studies · 932 participants | Moderate Downgraded: risk of bias, indirectness |
Number of people sustaining one or more fall‐related fractures Summary of findings for exercise vs control | Risk ratio 0.57 [0.28, 1.17] | 5 studies · 989 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Quality of life immediately after the intervention Summary of findings for exercise vs control | no estimate extracted | 5 studies · 951 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Summary of findings for exercise vs control | no estimate extracted | 8 studies · 1242 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Economic outcomes Summary of findings for exercise vs control | no estimate extracted | 4 studies · 923 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Summary of findings for cholinesterase inhibitors compared to placebo
Population: People with Parkinson's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person‐year) Summary of findings for cholinesterase inhibitors vs placebo | Rate ratio 0.5 [0.44, 0.58] | 3 studies · 229 participants | Low Downgraded: risk of bias, imprecision |
Number of people who experienced one or more falls Summary of findings for cholinesterase inhibitors vs placebo | no estimate extracted | 3 studies · 230 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Number of people sustaining one or more fall‐related fractures Summary of findings for cholinesterase inhibitors vs placebo | no estimate extracted | 1 study · 23 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Quality of Life immediately after the intervention (EQ5D Thermometer, scale 0 to 100; and EQ5D Index Score, scale 0‐1, high score is better quality of life) Summary of findings for cholinesterase inhibitors vs placebo | no estimate extracted | 1 study · 121 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Rate of adverse events excluding falls (per person year) Summary of findings for cholinesterase inhibitors vs placebo | Rate ratio 1.6 [1.28, 2.01] | 2 studies · 175 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Economic outcomes Summary of findings for cholinesterase inhibitors vs placebo | no estimate extracted | NR | No studies |
Summary of findings for education compared to control
Population: People with Parkinson's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person‐year) Summary of findings for education vs control | no estimate extracted | NR | No studies |
Number of people who experienced one or more falls Summary of findings for education vs control | Risk ratio 10.89 [1.26, 94.03] | 1 study · 53 participants | Very low Downgraded: risk of bias, imprecision |
Number of people sustaining one or more fall‐related fractures Summary of findings for education vs control | no estimate extracted | NR | No studies |
Quality of life Summary of findings for education vs control | no estimate extracted | NR | No studies |
Adverse events Summary of findings for education vs control | no estimate extracted | NR | No studies |
Economic outcomes Summary of findings for education vs control | no estimate extracted | NR | No studies |
Summary of findings for exercise plus education compared to control
Population: People with Parkinson's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of Falls (falls per person‐year) Summary of findings for exercise plus education vs control | Rate ratio 0.46 [0.12, 1.85] | 2 studies · 320 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Number of people who experienced one or more falls Summary of findings for exercise plus education vs control | Risk Ratio 0.89 [0.75, 1.07] | 3 studies · 352 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Number of people sustaining one or more fall‐related fractures Summary of findings for exercise plus education vs control | Risk ratio 1.45 [0.4, 5.32] | 2 studies · 320 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Quality of life immediately after the intervention Summary of findings for exercise plus education vs control | no estimate extracted | 2 studies · 305 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Adverse events Summary of findings for exercise plus education vs control | no estimate extracted | 2 studies · 343 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Economic Outcomes Summary of findings for exercise plus education vs control | no estimate extracted | 1 study · 133 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |