Objective: To study the effect of biofeedback (BFB) and balance training in patients with Parkinson disease (PD).

Background: Gait and balance disorders, characterized by freezing of gait and postural instability, represent a major therapeutic challenge in PD [1]. Stabilometry with BFB is used for diagnosis and rehabilitation of postural disorders. Equilibrium simulators have in their structure a pedoscan and a computer complex that converts information about the displacements of the common center of mass (GCM) into visual signals on the monitor screen.

Method: 30 patients, average age: 68 ± 4.6 years, 1.5 – 3.5 stage on Hoehn and Yahr scale of balance disorders, who are provided with regular antiparkinsonian therapy and have no acute pain. All attended 10 sessions of training, 2 times a week, 10 patients repeated the course again after 5 months. 1 hour of training included a session on a BFB-platform (DIERS, Germany) and a set of balance exercises. Every day all the participants performed special exercises by themselves at home. Before and after the course, patients were interviewed: UPDRS, Berg balance scale (BBS), ABC—scale, Tinneti, EQ-5D-5L, Schwabe-Ingland scale, PDQ-39 and stabilometry, statistic analysis using Microsoft Excel and variations of parametric statistical methods.

Results: After 10 sessions, all the patients showed an improvement in the quality of life by 15% on the Schwab-Ingland scale, a decrease in the PDQ-39 scale (p = 0.0005) and an improvement in the physical and mental health components on the SF-36 scale = 0.0005), as well as an improvement in walking and in balance on the Tinneti scale (p≤0.005) and a significant reduction in the risk of falls on the BBS (p≤0.008). Stabilometry analysis showed 7 mm expansion of the amplitude of the center of gravity (CG); alignment of fluctuations in the right and left CG in all planes regardless of the lateralization of symptoms.

Conclusion: A course of 10 sessions shows its effectiveness in reducing the risk of falls, improving balance control in the main vertical pose and when the CG shifts. Patients who underwent the second course had higher rates on the Tinneti and BB scales at the end of the course and subjectively noted confidence in walking and maintaining balance.

References: 1. David Grabli at al. Normal and pathological gait: what we learn from Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2012; 83 (10):10.1136/jnnp-2012-302263.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/complex-training-of-balance-in-parkinsons-disease/