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Singh G.1,2, Sharma N.2, Lyons K.E.3, Pahwa R.3, Colgrove Y.2
1Sage College, Physical Therapy, Troy, United States, 2University of Kansas Medical Center, Physical Therapy, Kansas City, United States, 3University of Kansas Medical Center, Neurology, Kansas City, United States
Background: Postural instability is a common feature of Parkinson´s disease (PD), which results in frequent falls.Exercise is known to improve motor and non-motor functions in PD; however there is scarcity of studies determining the efficacy of balance specific training, specifically using the Biodex stability system (BSS) in this population.
Purpose: The purpose of this study was to evaluate the effects of 4 weeks of BSS training on balance, gait and fatigue in PD patients.
Methods: This was a prospective, non-randomized pilot study in which 20 PD subjects with Hoehn and Yahr stages I III participated in balance training; 10 used BSS (BSS group) and 10 performed supervised balance exercise training without BSS (Non-BSS). Subjects participated in exercise sessions 3 times a week for 4 weeks for 55 minutes per session. Balance and gait were assessed using the Berg Balance Scale (BBS), forward reach test (FRT), and gait speed. Fatigue was assessed with the fatigue severity scale (FSS), and Timed Up and Go (TUG) and the 6 minute walk test (6MWT) were used to assess functional status. All assessments were performed at baseline and post exercise intervention.
Results: Significant between group differnece was found for fatigue only (p 0.02). Significant within groups differences (post pre, p-value) were found for the BBS (5.9, p 0.005), FRT (3.83 inches, p 0.005), gait velocity (0.13 m/s, p 0.009), TUG (1.87 sec, p 0.005), and 6 minute walk test (57.7 m, p 0.005) in the BSS group and for the Non-BSS group, significant within group difference was seen in the BBS (6.7, p 0.005), FRT (2.02 inches, p 0.01) , gait velocity (0.14 m/s, p 0.022), and TUG (-2.14 sec, p 0.005). Additionally, a significant within group change in fatigue severity scale was noted in BSS group only (-13.4, p 0.05).
Conclusion(s): Four weeks of exercise training using the BSS improved balance, gait speed and fatigue in adults with PD. However, improvements in balance and gait were also seen after an exercise program that did not use the BSS. This suggests that for the measures used in this study, both forms of balance training were beneficial and there were no differences between BSS training and general exercise balance training except for an a significantly greater improvement in fatigue with the BSS.
Implications: Balance training using BSS may be used as an adjunct to other physical therapy treatments to improve balance, gait and fatigue in individuals with PD.
Funding acknowledgements: N/A
Topic: Neurology: Parkinson's disease
Ethics approval: Approved by IRB of University of Kansas Medical Center, KS, USA
All authors, affiliations and abstracts have been published as submitted.
