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Article pour les cliniciens

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Les exercices prescrits à domicile améliorent les activités liées à l'équilibre chez les personnes atteintes de la maladie de Parkinson et présentent des avantages similaires à ceux des exercices en centre: une revue systématique.

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• Flynn A
• Allen NE
• Dennis S
• Canning CG
• Preston E

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Commentaires cliniques (en anglais)

General Internal Medicine-Primary Care(US)

This makes clinical and biologic sense and would be interesting to see whether people engaged in these programs ultimately have less falls/trauma, which is a risk in PD.

Geriatrics

In this meta-analysis by Flynn et al, data demonstrate that immediately after completion of a home-based exercise program, standardized balance-related and gait-speed scores significantly improved on average and were not statistically different from center-based scores. Not surprisingly, longer and more intense exercise programs were more successful. These data reverse conventional knowledge that center-based programs are more successful and supply evidence that clinicians should emphasize ongoing prescribed mobility programs for patients with Parkinson disease. In other words, an exercise prescription should be regularly added to medication for cognitively intact patients with Parkinson disease. What is lacking in this meta-analysis is detail about programs that work and don't work, and how to create an exercise prescription. Home health PT would be helpful, but many patients with Parkinson disease do not qualify because they are not home-bound. Strategies need to be developed for clinicians or their office staff to teach patients safe and effective exercises that can done at home.

Physical Medicine and Rehabilitation

A combination of small underpowered trials.

Physical Medicine and Rehabilitation

Home-based prescribed exercise improves balance-related activities and gait speed in people with mild to moderate Parkinson’s disease without substantial cognitive deficit. This benefit only lasts during the intervention phase and is similar to the benefits seen in center based physical therapy.