Session Information
Date: Monday, September 23, 2019
Session Title: Clinical Trials, Pharmacology and Treatment
Session Time: 1:45pm-3:15pm
Location: Agora 3 West, Level 3
Objective: To investigate whether the multimodal training is more effective in improving balance and gait in freezers versus non-freezers.
Background: Non-pharmacological interventions are increasingly used in the clinical management of gait problems in Parkinson’s disease (PD). However, the effects of cueing training on freezing of gait are suboptimal. We postulate that multimodal balance training might have an additional effect on freezing.
Method: 154 PD patients (Hoehn and Yahr stage 1-3 while ON medication) were assigned randomly to three groups: (1) balance training with rhythmical auditory cues delivered by a metronome (multimodal balance training); (2) standard balance training without rhythmical auditory cues; and (3) control intervention (educational program). Training was performed for 5 weeks, 2x/week. The primary outcome was the Mini-BESTest (MBEST) score directly after the training period. Assessments were performed by a single, blinded assessor at baseline, directly post-intervention, and after one and 6-months follow-up. Treatment effects for freezers and non-freezers were analyzed with a linear mixed model, adjusted for MBEST score, UPDRS scores and levodopa equivalent dose at baseline.
Results: Multimodal training significantly improved MBEST score post-intervention in both freezers and non-freezers compared to controls (P<0.001). Both patient groups retained their improvement at 1 and 6-months follow-up. Multimodal training significantly improved freezing of gait. Functional mobility (timed up and go) improved following both active interventions in the freezers, without difference between both interventions. All improvements were retained until 6-months follow-up.
Conclusion: Balance training combined with cueing is particularly effective in improving balance and gait in freezers.
To cite this abstract in AMA style:
T. Capato, N. de Vries, J. Inthout, J. Ramjith, E. Barbosa, J. Nonnekes, B. Bloem. A randomized clinical trial of multimodal balance training with rhythmical cues: effects on freezing of gait in Parkinson’s disease [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/a-randomized-clinical-trial-of-multimodal-balance-training-with-rhythmical-cues-effects-on-freezing-of-gait-in-parkinsons-disease/. Accessed June 14, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/a-randomized-clinical-trial-of-multimodal-balance-training-with-rhythmical-cues-effects-on-freezing-of-gait-in-parkinsons-disease/