OBJECTIVE: Deficits in step-to-step symmetry and trunk muscle activations have been linked to falls in Parkinson's disease (PD). Given such symptoms are poorly managed with anti-Parkinsonian medications, alternate therapies are needed. This blind phase II randomised-controlled trial sought to establish whether exercise can improve step-to-step symmetry in PD. DESIGN: Twenty-four PD patients with a falls history completed baseline assessments of symptom severity, balance confidence, mobility and quality of life. Step-to-step symmetry was assessed by deriving harmonic ratios from three-dimensional accelerations collected for the head and trunk. Patients were randomly assigned to either 12-weeks of exercise and falls prevention education or falls prevention education only. Both groups repeated the baseline tests 12- and 24-weeks following the initial assessment. The Australian and New Zealand Clinical Trials Registry number is ACTRN12613001175763. RESULTS: At 12-weeks, the Exercise group had statistically significant and clinically relevant improvements in anterior-posterior step-to-step trunk symmetry. In contrast, the Education group recorded statistically significant and clinically meaningful reductions in medial-lateral and vertical step-to-step trunk symmetry at 12-weeks. CONCLUSION: Given that step-to-step symmetry improved for the Exercise group and declined for the Education group post-intervention, active interventions appear more suited to increasing independence and quality of life for people with PD.

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