{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T04:42:28Z","timestamp":1765082548241,"version":"3.46.0"},"reference-count":69,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,11,25]]},"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Exercise has been shown to improve clinical measures of strength, balance and mobility, and in some cases, has improved symptoms of tremor and rigidity in people with Parkinson's disease (PD). However, to date, no research has examined whether improvements in trunk control can remedy deficits in dynamic postural stability in this population. The proposed randomised controlled trial aims to establish whether a 12-week exercise programme aimed at improving dynamic postural stability in people with PD; (1) is more effective than education; (2) is more effective when training frequency is increased; and (3) provides greater long-term benefits than education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\/design<\/jats:title>\n                    <jats:p>Forty-five community-dwelling individuals diagnosed with idiopathic PD with a falls history will be recruited. Participants will complete baseline assessments including tests of cognition, vision, disease severity, fear of falling, mobility and quality of life. Additionally, participants will complete a series of standing balance tasks to evaluate static postural stability, while dynamic postural control will be measured during walking using head and trunk-mounted three-dimensional accelerometers. Following baseline testing, participants will be randomly-assigned to one of three intervention groups, who will receive either exercise once per week, exercise 3\u2005days\/week, or education. Participants will repeat the same battery of tests conducted at baseline after the 12-week intervention and again following a further 12-week sustainability period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study has the potential to show that low-intensity and progressive trunk exercises can provide a non-invasive and effective means for maintaining or improving postural stability for people with PD. Importantly, if the programme is noted to be effective, it could be easily performed by patients within their home environment or under the guidance of available allied health professionals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613001175763).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-006095","type":"journal-article","created":{"date-parts":[[2014,12,31]],"date-time":"2014-12-31T23:04:30Z","timestamp":1420067070000},"page":"e006095","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Trunk muscle exercises as a means of improving postural stability in people with Parkinson's disease: a protocol for a randomised controlled trial"],"prefix":"10.1136","volume":"4","author":[{"given":"Ryan P","family":"Hubble","sequence":"first","affiliation":[{"name":"School of Exercise Science, Australian Catholic University, Brisbane, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geraldine A","family":"Naughton","sequence":"additional","affiliation":[{"name":"School of Exercise Science, Australian Catholic University, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter A","family":"Silburn","sequence":"additional","affiliation":[{"name":"The University of Queensland, Centre for Clinical Research, Brisbane, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1817-7528","authenticated-orcid":false,"given":"Michael H","family":"Cole","sequence":"additional","affiliation":[{"name":"School of Exercise Science, Australian Catholic University, Brisbane, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,12,31]]},"reference":[{"key":"2025120619164509000_4.12.e006095.1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23292"},{"key":"2025120619164509000_4.12.e006095.2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.72.6.721"},{"key":"2025120619164509000_4.12.e006095.3","doi-asserted-by":"publisher","DOI":"10.1097\/01.wco.0000137530.68867.93"},{"key":"2025120619164509000_4.12.e006095.4","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20115"},{"key":"2025120619164509000_4.12.e006095.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-006-0353-6"},{"key":"2025120619164509000_4.12.e006095.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2007.07.002"},{"key":"2025120619164509000_4.12.e006095.7","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2001.21859"},{"key":"2025120619164509000_4.12.e006095.8","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/60.10.1310"},{"key":"2025120619164509000_4.12.e006095.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2007.06.009"},{"key":"2025120619164509000_4.12.e006095.10","doi-asserted-by":"crossref","unstructured":"Winter DA . Biomechanics and motor control of human movement. John Wiley & Sons, 2009.","DOI":"10.1002\/9780470549148"},{"key":"2025120619164509000_4.12.e006095.11","doi-asserted-by":"crossref","first-page":"255","DOI":"10.2519\/jospt.2001.31.5.255","article-title":"Sagittal plane analysis of head, neck, and trunk kinematics and electromyographic activity during locomotion","volume":"31","author":"Cromwell","year":"2001","journal-title":"J Orthop Sports Phys Ther"},{"key":"2025120619164509000_4.12.e006095.12","first-page":"285","article-title":"Accelerographic analysis of several types of walking","volume":"50","author":"Smidt","year":"1971","journal-title":"Am J Phys Med Rehabil"},{"key":"2025120619164509000_4.12.e006095.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0966-6362(02)00159-5"},{"key":"2025120619164509000_4.12.e006095.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2006.06.007"},{"key":"2025120619164509000_4.12.e006095.15","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22561"},{"key":"2025120619164509000_4.12.e006095.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2011.05.019"},{"key":"2025120619164509000_4.12.e006095.17","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23082"},{"key":"2025120619164509000_4.12.e006095.18","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2006.099333"},{"key":"2025120619164509000_4.12.e006095.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2007.09.031"},{"key":"2025120619164509000_4.12.e006095.20","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-11-93"},{"key":"2025120619164509000_4.12.e006095.21","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/1471-2377-12-54","article-title":"Protocol for a home-based integrated physical therapy program to reduce falls and improve mobility in people with Parkinson's disease","volume":"12","author":"Morris","year":"2012","journal-title":"BMC Neurol"},{"key":"2025120619164509000_4.12.e006095.22","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/32.4.407"},{"key":"2025120619164509000_4.12.e006095.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2010.01.001"},{"key":"2025120619164509000_4.12.e006095.24","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1017\/S1368980099000567","article-title":"The influence of physical activity on mental well-being","volume":"2","author":"Fox","year":"1999","journal-title":"Public Health Nutr"},{"key":"2025120619164509000_4.12.e006095.25","first-page":"CD004366","article-title":"Exercise for depression","volume":"9","author":"Cooney","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"2025120619164509000_4.12.e006095.26","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007146.pub3"},{"key":"2025120619164509000_4.12.e006095.27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.02014.x"},{"key":"2025120619164509000_4.12.e006095.28","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20475"},{"key":"2025120619164509000_4.12.e006095.29","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5004"},{"key":"2025120619164509000_4.12.e006095.30","first-page":"CD002817","article-title":"Physiotherapy versus placebo or no intervention in Parkinson's disease","volume":"8","author":"Tomlinson","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"2025120619164509000_4.12.e006095.31","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1016\/j.parkreldis.2014.09.008","article-title":"Back to the basics: regular exercise matters in Parkinson's disease: results from the National Parkinson Foundation registry study","volume":"20","author":"Oguh","year":"2014","journal-title":"Parkinsonism Relat Disord"},{"key":"2025120619164509000_4.12.e006095.32","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/2047-9158-3-5","article-title":"The effects of exercise on cognition in Parkinson's disease: a systematic review","volume":"3","author":"Murray","year":"2014","journal-title":"Transl neurodegen"},{"key":"2025120619164509000_4.12.e006095.33","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1107911"},{"key":"2025120619164509000_4.12.e006095.34","doi-asserted-by":"crossref","unstructured":"Tomlinson CL , Herd CP , Clarke CE , et al . Physiotherapy for Parkinson's disease: a comparison of techniques. Cochrane Database Syst Rev 2014;6:CD002815.","DOI":"10.1002\/14651858.CD002815.pub2"},{"key":"2025120619164509000_4.12.e006095.35","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-8-18"},{"key":"2025120619164509000_4.12.e006095.36","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.55.3.181"},{"key":"2025120619164509000_4.12.e006095.37","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22352"},{"key":"2025120619164509000_4.12.e006095.38","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000434309.85312.19"},{"key":"2025120619164509000_4.12.e006095.39","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-197611000-00006"},{"key":"2025120619164509000_4.12.e006095.40","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1212\/WNL.50.2.318","article-title":"Parkinsonism: onset, progression, and mortality","volume":"50","author":"Hoehn","year":"1998","journal-title":"Neurology"},{"key":"2025120619164509000_4.12.e006095.41","unstructured":"Schwab RS , England AC . Projection technique for evaluating surgery in Parkinson's disease. Third symposium on Parkinson's disease. Edinburgh: Livingstone, 1969."},{"key":"2025120619164509000_4.12.e006095.42","doi-asserted-by":"publisher","DOI":"10.1016\/S1353-8020(99)00062-0"},{"key":"2025120619164509000_4.12.e006095.43","doi-asserted-by":"crossref","first-page":"M28","DOI":"10.1093\/gerona\/50A.1.M28","article-title":"The activities-specific balance confidence (ABC) scale","volume":"50","author":"Powell","year":"1995","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2025120619164509000_4.12.e006095.44","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","article-title":"The timed \u201cUp & Go\u201d: a test of basic functional mobility for frail elderly persons","volume":"39","author":"Podsiadlo","year":"1991","journal-title":"J Am Geriatr Soc"},{"key":"2025120619164509000_4.12.e006095.45","doi-asserted-by":"publisher","DOI":"10.1007\/BF02260863"},{"key":"2025120619164509000_4.12.e006095.46","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20213"},{"key":"2025120619164509000_4.12.e006095.47","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-1313.1988.tb01170.x"},{"key":"2025120619164509000_4.12.e006095.48","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/1353-8020(95)00002-X","article-title":"Intermediate scale for assessment of Parkinson's disease. Characteristics and structure","volume":"1","author":"Martinez-Martin","year":"1995","journal-title":"Parkinsonism Relat Disord"},{"key":"2025120619164509000_4.12.e006095.49","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10248"},{"key":"2025120619164509000_4.12.e006095.50","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181e7b688"},{"key":"2025120619164509000_4.12.e006095.51","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-0033(98)00090-4"},{"key":"2025120619164509000_4.12.e006095.52","doi-asserted-by":"publisher","DOI":"10.1016\/0013-4694(87)90003-4"},{"key":"2025120619164509000_4.12.e006095.53","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1093\/ptj\/78.6.566","article-title":"Trunk muscle performance in early Parkinson's disease","volume":"78","author":"Bridgewater","year":"1998","journal-title":"Phys Ther"},{"key":"2025120619164509000_4.12.e006095.54","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/S1050-6411(02)00097-4","article-title":"Evolution in impedance at the electrode-skin interface of two types of surface EMG electrodes during long-term recordings","volume":"13","author":"Hewson","year":"2003","journal-title":"J Electromyogr Kinesiol"},{"key":"2025120619164509000_4.12.e006095.55","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2009.03.010"},{"key":"2025120619164509000_4.12.e006095.56","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2003.10.004"},{"key":"2025120619164509000_4.12.e006095.57","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10218"},{"key":"2025120619164509000_4.12.e006095.58","first-page":"1499","article-title":"Comparisons of berg balance scale following core stabilization training in women elderly","volume":"3","author":"Hesari","year":"2012","journal-title":"Ann Biol Res"},{"key":"2025120619164509000_4.12.e006095.59","doi-asserted-by":"crossref","first-page":"139","DOI":"10.3109\/09593989709036457","article-title":"Trunk muscle training and early Parkinson's disease","volume":"13","author":"Bridgewater","year":"1997","journal-title":"Physiother Theory Pract"},{"key":"2025120619164509000_4.12.e006095.60","doi-asserted-by":"publisher","DOI":"10.1177\/1545968310376057"},{"key":"2025120619164509000_4.12.e006095.61","doi-asserted-by":"publisher","DOI":"10.1249\/01.MSS.0000078924.61453.FB"},{"key":"2025120619164509000_4.12.e006095.62","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1079\/PHN2005898","article-title":"The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity","volume":"9","author":"Hagstromer","year":"2006","journal-title":"Public Health Nutr"},{"key":"2025120619164509000_4.12.e006095.63","doi-asserted-by":"publisher","DOI":"10.1249\/01.MSS.0000117161.66394.07"},{"key":"2025120619164509000_4.12.e006095.64","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awp229"},{"key":"2025120619164509000_4.12.e006095.65","doi-asserted-by":"publisher","DOI":"10.1097\/01.jsm.0000244612.55550.7d"},{"key":"2025120619164509000_4.12.e006095.66","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21922"},{"key":"2025120619164509000_4.12.e006095.67","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(03)00046-7"},{"key":"2025120619164509000_4.12.e006095.68","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.parkreldis.2006.07.018","article-title":"Clinical relevance of rehabilitation programs for patients with idiopathic Parkinson syndrome. II: symptom-specific therapeutic approaches","volume":"13","author":"J\u00f6bges","year":"2007","journal-title":"Parkinsonism Relat Disord"},{"key":"2025120619164509000_4.12.e006095.69","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1002\/pri.1571","article-title":"The Otago Exercise Program performed as group training versus home training in fall-prone older people: a randomized controlled Trial","volume":"19","author":"Kyrdalen","year":"2014","journal-title":"Physiother Res Int"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2014-006095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T03:17:02Z","timestamp":1765077422000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2014-006095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,12]]},"references-count":69,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2014,12,31]]},"published-print":{"date-parts":[[2014,12]]}},"alternative-id":["10.1136\/bmjopen-2014-006095"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2014-006095","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2014,12]]}}}