Empowering safer mobility behaviour for fall prevention in Parkinson’s disease: An allied health perspective

Introduction

Safer mobility behaviour involves the use of protective actions and functional cognitive processes to reduce the chances of falling. Physiotherapists and occupational therapists have a well-established role in improving functional independence however their approach to promoting safer mobility behaviour for fall prevention is unknown. This study aims to understand the perspectives of clinicians and researchers on the nature of safer mobility behaviour and how it is implemented in clinical practice.

Methods

A qualitative study using focus group discussions was conducted. Participants included 1) physiotherapists and occupational therapists (>5 years’ experience in treating 50 or more people with Parkinson’s disease [PwPD]) and/or 2) researchers (published ≥2 studies on fall prevention in PwPD). Focus group discussions using an open-ended topic guide facilitated deeper discussions between these experts. Data was inductively analysed using reflexive thematic analysis.

Results

Nineteen participants took part across five focus groups. The central theme underpinning clinical practice was empowering people towards safer mobility behaviour. This meant enabling rather than restricting PwPD to engage in activities that were meaningful to them as safely as possible. Empowerment was demonstrated across three subthemes. Firstly, a contextual approach involved clinicians understanding the complexity of mobility behaviour and the added burden of Parkinson’s disease. Secondly, an individual approach was used to tailor assessments and interventions. Thirdly, a collaborative approach was needed between clinicians, individuals, their families and the wider multidisciplinary team.

Conclusion

This study reframes promoting mobility safety as a positive, empowering experience rather than being restrictive or prescriptive. It recognises individual autonomy and the right of PwPD to make choices, alongside the role of clinicians as collaborators to develop safer movement strategies. This framework provides valuable insight towards the effective implementation of a safer mobility behavioural approach to fall prevention in PwPD.