Effectiveness of robotic balance training on postural instability in patients with mild Parkinson's disease: A pilot, single blind, randomized controlled trial

Abstract

Objective To examine whether tailored robotic platform training could improve postural stability compared with conventional balance treatment in patients with mild Parkinson’s disease. Design Randomized single-blind pilot study. Subjects Twenty-two patients with mild Parkinson’s disease (Hoehn & Yahr scale; H&Y 1–2). Methods Patients were randomly assigned to an experimental group for robotic balance training and to a control group for conventional balance training. Each patient received 20 treatments (45 min/session, 5 times/week). Blinded evaluations were conducted before and after the treatment and 1 month post-treatment. Primary outcome measures were Mini BESTest, and Berg Balance Scale; secondary outcome measures were 10-Meter Walk Test, Five Times Sit to Stand Test, and Parkinson’s Disease Questionnaire 39. Results Primary outcome measures in patients in both the experimental and control groups improved significantly after the balance treatment. Similar results were found for all the secondary outcome measures. The experimental group performed significantly better than the control group at both post-intervention and follow-up evaluation in the primary outcomes ( p < 0.05). No significant differences between groups were found in secondary outcomes. Conclusion Robot-assisted balance training may be a promising tool to improve postural stability in patients with mild Parkinson’s disease. LAY ABSTRACT More than 10 million people worldwide are living with Parkinson’s disease. Parkinson’s disease is a slowly progressive neurodegenerative disorder that leads to balance problems. Balance is a major concern in patients with Parkinson’s disease, and shows poor response to pharmacological treatment. It is known that exercise and physiotherapy can help. The best approach is to start exercising at the early stages of the disease with personalized rehabilitation treatment. This study explored the effectiveness of a new robotic platform treatment on balance compared with the conventional approach. Both trainings were found to improve balance, walking and quality of life. However, robotic balance training could have a major impact. The robotic device enables the training to be intense, fun, task-oriented, challenging and personalized, enhancing motor learning and neuroplasticity. This advance in rehabilitation technology could help to meet the challenges presented by Parkinson’s disease.

Evaluation of a novel technology-supported fall prevention intervention – study protocol of a multi-centre randomised controlled trial in older adults at increased risk of falls

“…Although several studies in recent years used miscellaneous new technology within novel fall prevention interventions [ 23 – 28 ], so far, the potential contribution of the hunova robot (Movendo Technology, Genoa, Italy) to reducing fall risk has not been investigated. Based on clinical studies that demonstrated positive results in the rehabilitation of stroke patients as well as in patients with Parkinson’s disease (PD) [ 37 , 38 ]. Cella et al [ 35 ] demonstrated that the hunova robot can discriminate and evaluate older patients and predict falls.…”

“…All details can be found in Cella and colleagues and Saglia et al [ 35 , 36 ]. First clinical studies have demonstrated positive results in the rehabilitation of stroke patients, as well as in patients with Parkinson’s disease (PD) [ 37 , 38 ]. As a new approach, we use a novel technology (hunova robot), developed and used previously for specific diseases, now moving into older adult research, particularly fall prevention.…”

The minimal important change for measures of balance and postural control in older adults: a systematic review

“…For example, Spina et al. [ 44 ] demonstrated that following balance training, individuals with mild Parkinson’s Disease (PD) showed a 3.45-point difference for the Mini-BESTest, which was significant to P < 0.016. This difference is smaller than the 4-point MIC reported by Godi [ 27 ] for a similar population.…”

Movement therapy in advanced heart failure assisted by a lightweight wearable robot: a feasibility pilot study

“…As a result, longer duration of the exercise sessions and a higher training intensity can be achieved. [7][8][9][10][11] To date, this innovative approach has not been applied in cardiovascular rehabilitation training, despite its great potential to counteract the deconditioning experienced by patients with symptomatic chronic heart failure. The aim of this pilot study was to investigate the safety, feasibility, and tolerability of exoskeleton-type robotic-assisted mobilization protocols in patients with severe heart failure.…”

“…Robotic assistance can augment the effect of physical training by facilitating motor recovery, supporting balance and stability and thus improving exercise capacity to a greater degree than conventional, non‐assisted training. As a result, longer duration of the exercise sessions and a higher training intensity can be achieved 7–11 …”