Effects of perceptive rehabilitation on balance control in patients with Parkinson's disease

Abstract

BACKGROUND: Subjects affected by Parkinson's disease have substantially impaired static and dynamic balance, leading to diminished functional ability. Conventional and innovative exercises have been suggested, but most of them were focused on motor features of posture and gait, deserving poor attention to perceptive aspects of balance. OBJECTIVE: To evaluate the efficacy of the perceptive rehabilitation, based on perceptual surfaces, for postural balance (primary aim) and pain, depression and activity daily living. METHODS: In this pilot study, we have treated 9 patients with Parkinson's disease undergone rehabilitation aiming to restoring their correct body midline perception, according a schema treatment -no treatment -treatment. RESULTS: During the rehabilitative intervention, both Tinetti balance score (p = 0.007 in both phases) and Tinetti gait score (p = 0.011 and p = 0.016, respectively), such as pain relief assessed by Visual Analogue Scale (p = 0.011, p = 0.010) were improved. Conversely in the phase of no-intervention, lasting the same amount of time, it was showed a significant reduction of Tinetti Balance score (p = 0.010) and no significant changes in terms of Tinetti Gait score and Visual Analogue Scale. CONCLUSIONS: These preliminary results highlighted the importance of introducing perceptive training into the exercises proposed to patients with Parkinson's disease for reducing both their static and dynamic balance impairments.

Tactile and proprioceptive sensory stimulation modifies estimation of walking distance but not upright gait stability: a pilot study

“…Also, the maintenance of chronic low back pain is linked to a disorder of altered perception of the trunk 23 ) . Perceptual Surfaces (PSs) reduce static and dynamic balance impairments, even in patients with Parkinson disease (PD) 24 ) . The function of the trunk is crucial in PD: other studies have shown how vibrotactile biofeedback of the trunk improves postural stability in PD 25 ) .…”

Postural Abnormality in Parkinson's Disease: A Large Comparative Study With General Population

“…Rehabilitation to correct abnormal posture demonstrated inverse (left‐sided) correlation. Paolucci et al also reported the efficacy of perceptive training for treating balance impairment in PD patients.…”

A New Rehabilitation Tool in Fibromyalgia: The Effects of Perceptive Rehabilitation on Pain and Function in a Clinical Randomized Controlled Trial

“…(A) Perceptive Rehabilitation Program . Perceptive surface group (PS-group) received a treatment that, as described by Morone and colleagues [ 36 – 38 ], is a therapeutic approach based on the interaction between the patient's back or painful area and a support surface, composed of small latex cones with various dimensions (height: 3–8 cm; base diameter: 2–4 cm) and elasticities. The inferior bases of these cones are applied to a rigid wood surface using elastic strips; normally, over 100 cones are used for each session ( Figure 2 ).…”

“… In subsequent sessions, cones with varying elasticities were positioned by the therapist to improve the symmetry of contact between the surface and the patient's back, taking into consideration the hyperemia in the previous session. The objective of this step was to obtain reafferent information from the trunk and body, the positions of which were altered in FM, using elements of motor imagery [ 38 – 41 ]. Each phase of the session ended with 10 minutes of global stretching of the upper limbs and lower limbs.…”