OBJECTIVE: To examine the effects of technology-assisted balance and gait training on reducing falls in patients with Parkinson’s disease (PD). METHODS: Eligible subjects were randomly allocated to an experimental group given technology-assisted balance and gait training (BAL, n = 26) and an active control group undertaking strengthening exercises (CON, n = 25). The training in each group lasted for 3 months. The number of fallers and fall rate were used as primary outcomes, and single-leg-stance-time, latency of postural response to perturbation, self-selected gait velocity, and stride length as secondary outcomes. Fall incidence was recorded over 15 months after the baseline assessment (Pre). Other tests were performed at Pre, after 3-month intervention (Post<sub>3m</sub>), at 3 months (Post<sub>6m</sub>), and 12 months (Post<sub>15m</sub>) after treatment completion. RESULTS: Forty-five subjects who completed the 3-month training were included in the data analysis. There were fewer fallers in the BAL than in the CON group at Post<sub>3m</sub>, Post<sub>6m</sub>, and Post<sub>15m</sub> (<i>P</i> < .05). In addition, the BAL group had lower fall rate than the CON group at Post<sub>3m</sub> and Post<sub>6m</sub> (incidence rate ratio: 0.111-0.188, <i>P</i> < .05), and marginally so at Post<sub>15m</sub> (incidence rate ratio: 0.407, <i>P</i> = .057). Compared with the CON subjects, the BAL subjects demonstrated greater reduction in the postural response latency and increase in the stride length against baseline at each assessment interval (<i>P</i> < .05), and marginally more increases of single-leg-stance-time at Post<sub>3m</sub> (<i>P</i> = .064), Post<sub>6m</sub> (<i>P</i> = .041) and Post<sub>15m</sub> (<i>P</i> = .087). CONCLUSIONS: Our positive findings provide evidence for the clinical use of technology-assisted balance and gait training in reducing falls in people with PD. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
BACKGROUND: Fear of falling has been identified as an important and independent fall-risk predictor in patients with Parkinson’s disease (PD). However, there are inconsistent findings on the effects of balance and gait training on balance confidence. OBJECTIVE: To explore whether balance and gait training with augmented feedback can enhance balance confidence in PD patients immediately after treatment and at 3- and 12-month follow-ups. Methods. A total of 51 PD patients were randomly assigned to a balance and gait training (BAL) group or to an active control (CON) group. The BAL group received balance and gait training with augmented feedback, whereas CON participants received lower-limb strength training for 12 weeks. Outcome measures included Activities-Specific Balance Confidence (ABC) Scale, limits-of-stability test, single-leg-stance test, and spatiotemporal gait characteristics. All tests were administered before intervention (Pre), immediately after training (Post), and at 3 months (Post<sub>3m</sub>) and 12 months (Post<sub>12m</sub>) after treatment completion. RESULTS: The ABC score improved marginally at Post and significantly at Post<sub>3m</sub> and Post<sub>12m</sub> only in the BAL group (<i>P</i> < .017). Both participant groups increased their end point excursion at Post, but only the BAL group maintained the improvement at Post<sub>3m</sub>. The BAL group maintained significantly longer time-to-loss-of-balance during the single-leg stance test than the CON group at Post<sub>3m</sub> and Post<sub>12m</sub> (<i>P</i> < .05). For gait characteristics, both participant groups increased gait velocity, but only the BAL group increased stride length at Post, Post<sub>3m</sub>, and Post<sub>12m</sub> (<i>P</i> < .017). CONCLUSIONS: Positive findings from this study provide evidence that BAL with augmented feedback could enhance balance confidence and balance and gait performance in patients with PD. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
