Abstract
BackgroundPatients with Parkinson's disease (PD) suffer from dysrhythmic and disturbed gait, impaired balance, and decreased postural responses. These alterations lead to falls, especially as the disease progresses. Based on the observation that postural control improved in patients with vestibular dysfunction after audio-biofeedback training, we tested the feasibility and effects of this training modality in patients with PD.MethodsSeven patients with PD were included in a pilot study comprised of a six weeks intervention program. The training was individualized to each patient's needs and was delivered using an audio-biofeedback (ABF) system with headphones. The training was focused on improving posture, sit-to-stand abilities, and dynamic balance in various positions. Non-parametric statistics were used to evaluate training effects.ResultsThe ABF system was well accepted by all participants with no adverse events reported. Patients declared high satisfaction with the training. A significant improvement of balance, as assessed by the Berg Balance Scale, was observed (improvement of 3% p = 0.032), and a trend in the Timed up and go test (improvement of 11%; p = 0.07) was also seen. In addition, the training appeared to have a positive influence on psychosocial aspects of the disease as assessed by the Parkinson's disease quality of life questionnaire (PDQ-39) and the level of depression as assessed by the Geriatric Depression Scale.ConclusionsThis is, to our knowledge, the first report demonstrating that audio-biofeedback training for patients with PD is feasible and is associated with improvements of balance and several psychosocial aspects.
Highlights
Postural instability, gait disturbances and falls are a leading cause of morbidity and mortality among older adults [1,2,3,4,5,6], especially among patients suffering from a neurodegenerative disease like Parkinson’s disease (PD)
Because of the tremendous impact of falls on functional independence, health care economics, social function and health-related quality of life, much effort has been dedicated to identify the physiologic factors that contribute to fall risk. This includes prospectively monitoring those individuals with an increased fall risk and developing interventions for improving balance control and reducing falls [1,2,3,4,5,6]
While much is known at the present about the multifactorial nature of gait disturbances and falls in PD, there are still many questions regarding the best therapeutic means of improving these impairments and reducing fall risk
Summary
Gait disturbances and falls are a leading cause of morbidity and mortality among older adults [1,2,3,4,5,6], especially among patients suffering from a neurodegenerative disease like Parkinson’s disease (PD). Because of the tremendous impact of falls on functional independence, health care economics, social function and health-related quality of life, much effort has been dedicated to identify the physiologic factors that contribute to fall risk This includes prospectively monitoring those individuals with an increased fall risk and developing interventions for improving balance control and reducing falls [1,2,3,4,5,6]. Specific forms of exercise have been recommended as elements of fall-prevention programs for older adults, for example, aerobic-type exercises and exercises that target balance, strength and gait are common elements of multi-factorial fall prevention interventions [12,13,14] Typically, these interventions report a reduction in fall risk by only 10% to 20% [15,16] and are not yet optimal. Based on the observation that postural control improved in patients with vestibular dysfunction after audio-biofeedback training, we tested the feasibility and effects of this training modality in patients with PD
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