The Effects of a Postural Balance Training Program on Balance, Gait and Health-Related Quality of Life in Patients with Essential Tremor

Abstract

Objective: Although the effectiveness of postural balance training on balance and gait impairment has been proven as an effective treatment approach in several patient and healthy populations, its effectiveness in patients with essential tremor (ET) is yet unknown. The aim was to examine the effects of postural balance training program on balance and gait performance, and health-related quality of life in patients with ET. Materials and Methods: This uncontrolled clinical study included patients with ET. The outcome measures were the Postural Stability Test, Limits of Stability Test, Fall Risk Test, Activities-Specific Balance Confidence scale, Dynamic Gait Index, and Short Form-36. The assessments were performed before and after the training program. The participants underwent an 8-week balance training designed to improve their ability to integrate multisensory inputs and postural control using a computerized balance assessment and training device. Results: In total, 24 patients with ET participated in the study. The compliance rate was 87.5%. There were significant improvements in all outcome measures of balance and gait performance, balance confidence, fall risk, and health-related quality of life (except the mental component, p>0.05) between baseline and 8 weeks (p<0.05). Conclusion: Our results suggest that the balance training program is a feasible method that may have positive effects on balance performance and confidence, gait performance, and health-related quality of life in patients with ET. Keywords: Balance training, essential tremor, gait, quality of life Amaç: Postürel denge eğitiminin çeşitli hastalıklarda ve sağlıklılarda denge ve yürüme bozukluğu için etkin bir tedavi yaklaşımı olarak kanıtlanmış olmasına rağmen esansiyel tremorlu (ET) hastalarda etkinliği henüz bilinmemektedir. Bu çalışmanın amacı, postürel denge eğitim programının ET'li hastalardaki denge, yürüme performansı ve sağlıkla ilgili yaşam kalitesi üzerine etkilerini incelemek idi. Gereç ve Yöntem: Bu kontrolsüz klinik çalışmaya ET'li hastalar dahil edildi. Sonuç ölçümleri Postürel Stabilite Testi, Stabilite Testi Sınırları, Güz Risk Testi, Aktivitelere Özgü Denge Güven Ölçeği, Dinamik Yürüme İndeksi ve Kısa Form-36'dan oluşmaktaydı. Değerlendirmeler, eğitim programından önce ve sonra gerçekleştirildi. Katılımcılar, bilgisayar tabanlı denge değerlendirme ve eğitim cihazı ile çoklu duyusal girdileri ve postürel kontrolleri bütünleştirme yeteneklerini geliştirmek için tasarlanmış 8 haftalık bir denge eğitimine tabi tutuldu. Bulgular: Çalışmaya toplam 24 ET'li hasta katıldı. Programı tamamlama oranı %87,5 idi. Sekiz haftanın sonunda denge ve yürüme performansı, denge güveni, düşme riski ve sağlıkla ilgili yaşam kalitesini içeren (zihinsel bileşen hariç, p>0,05) tüm sonuç ölçümlerinde anlamlı iyileşmeler tespit edildi (p<0,05). Sonuç: Bu çalışmanın bulguları, denge eğitim programının ET'li hastalardaki denge performansı ve güvenini, yürüme performansını ve sağlıkla ilgili yaşam kalitesini olumlu etkileyebilecek uygun bir yöntem olduğun...

Multisensory Exercise Improves Balance in People with Balance Disorders: A Systematic Review

“…Two studies collected and reported information about multisensory exercise, which included participants all females [31,32] . Of these participants, 30 were ataxic patients [33] , 73 were older adults with a history of falls [20,34,35] , 33 were older adults without fall history [35,36] , 18 were older adults with visual impairment [37] , 16 were diabetics with peripheral neuropathy [38] , and 21 were patients with essential tremor [39] . A total of 667 participants were included in the 20 studies, four studies were conducted in the United States, four in Canada, two in Brazil, and two in France, other studies in England, Indian, Sweden, and so on.…”

“…The total time spent in exercising during the multisensory exercise interventions varied from 0.5 [30,40] to 180 h [33] , while the intervention duration ranged from 2 [41] to 16 weeks [31] . Studies of intervention time showed that multisensory exercises worked within 6 weeks [34,38,42] , 8 weeks [20,39,43] , 12 weeks [36,37,44] ) respectively. However, there are still studies which reported effective intervention duration was less than 6 weeks or more than 12 weeks.…”

“…One study [46] used three groups: one control group (conventional training included balance tasks in seated, standing, and moving task situations), one group of individual Dual-Task Training, and one group of multisensory training. Five studies [28,33,34,39,42] used only one group in their study design. The other studies used two groups (intervention group and control group).…”