Effect of Balance Training on Postural Instability in Patients With Idiopathic Parkinson’s Disease

TLDR

Postural instability is a disabling sign of Parkinson’s disease that is not readily improved by medication. The study aimed to evaluate the effects of a structured balance‑training program on postural instability in patients with Parkinson’s disease. Sixty‑four PD patients with postural instability were randomized to 21 50‑minute balance‑training sessions or to general physical exercise, and outcomes were assessed pre‑, post‑, and 1‑month using the Berg Balance Scale, Activities‑Specific Balance Confidence Scale, postural transfer test, center‑of‑pressure destabilization, fall count, UPDRS, Hoehn‑Yahr staging, and GDS. Balance training produced significant improvements in all measured balance and fall‑related outcomes (except UPDRS and Hoehn‑Yahr) that were maintained at 1‑month follow‑up, while the control group showed no changes, indicating that balance training can improve postural instability in Parkinson.

Abstract

Postural instability (PI) is a disabling sign of Parkinson's disease (PD) not easily amenable to treatment with medication.To evaluate the effects of balance training on PI in patients with PD.A total of 64 patients with PI were randomly assigned to the experimental group (n = 33) for balance training or to the control group (n = 31) for general physical exercises. Each patient received 21 treatment sessions of 50 minutes each. Patients were evaluated by a blinded rater before and after treatment as well as 1 month posttreatment using the Berg Balance Scale (BBS), Activities-Specific Balance Confidence Scale (ABC), postural transfer test, self-destabilization of the center of foot pressure test, number of falls, Unified Parkinson's Disease Rating Scale (UPDRS), modified Hoehn and Yahr (H&Y) Staging Scale, and Geriatric Depression Scale (GDS).At the end of treatment, the experimental group showed significant improvements in all outcome measures, except for the UPDRS and the H&Y scale. Improvement was maintained at the 1-month follow-up in all outcome measures except for the GDS. No significant changes in performance were observed in the control group.A program of balance training can improve PI in patients with PD.