Wearable Sensor-Based Biofeedback Training for Balance and Gait in Parkinson Disease: A Pilot Randomized Controlled Trial

Carpinella, Ilaria; Cattaneo, Davide; Bonora, Gianluca; Bowman, Thomas G.; Martina, L.; Montesano, Angelo; Ferrarin, Maurizio

doi:10.1016/j.apmr.2016.11.003

Cited by 87 publications

(195 citation statements)

References 37 publications

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“…One high‐quality study evaluated virtual reality combined with treadmill training that reduced falls when compared with treadmill alone . A lower quality study using a gamepad with avatar was positive compared to physiotherapy . A lower quality study evaluating a home virtual reality device versus home conventional balance exercises was positive in both groups .…”

Section: Results and Conclusionmentioning

confidence: 99%

“…78 A lower quality study using a gamepad with avatar was positive compared to physiotherapy. 79 A lower quality study evaluating a home virtual reality device versus home conventional balance exercises was positive in both groups. 80 In contrast, 2 high-quality studies were negative; 1 using an avatar versus conventional balance training for balance 81 and 1 evaluating robotic gait training versus balance training.…”

Section: New Conclusion For Adjunct Therapies For Specific or Generamentioning

confidence: 99%

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International Parkinson and movement disorder society evidence‐based medicine review: Update on treatments for the motor symptoms of Parkinson's disease

et al. 2018

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Section: Results and Conclusionmentioning

confidence: 99%

Section: New Conclusion For Adjunct Therapies For Specific or Generamentioning

confidence: 99%

International Parkinson and movement disorder society evidence‐based medicine review: Update on treatments for the motor symptoms of Parkinson's disease

et al. 2018

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“…The scores obtained on the PEDro scale are shown in Table 2. Nine RCTs had high methodological quality with scores on the scale equal to or greater than 6: Picelli et al [11], Nimwegen et al [28], Volpe et al [29], Volpe et al [30], Monticone et al [31], Hashimoto et al [32], Rios Romenets et al [33], Volpe et al [34], and Carpinella et al [35]. Shujaat et al [36] and Ricciardi et al [10] scored 5, obtaining the lowest score.…”

Section: Assessment Of the Methodological Quality Of The Rcts Includementioning

confidence: 99%

Additional Physical Interventions to Conventional Physical Therapy in Parkinson’s Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Hidalgo-Agudo

Lucena-Antón

Luque-Moreno

et al. 2020

JCM

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Parkinson's disease (PD) represents the second most common neurodegenerative disease. Currently, conventional physical therapy is complemented by additional physical interventions with recreational components, improving different motor conditions in people with PD. This review aims to evaluate the effectiveness of additional physical interventions to conventional physical therapy in Parkinson's disease. A systematic review and meta-analysis of randomized controlled trials were performed. The literature search was conducted in PubMed, Physiotherapy Evidence Database (PEDro), Scopus, SciELO and Web of Science. The PEDro scale was used to evaluate the methodological quality of the studies. A total of 11 randomized controlled trials were included in this review. Five of them contributed information to the meta-analysis. The statistical analysis showed favorable results for dance-based therapy in motor balance: (Timed Up and Go: standardized mean difference (SMD) = −1.16; 95% Confidence Interval (CI):(−2.30 to −0.03); Berg Balance Scale: SMD = 4.05; 95%CI:(1.34 to 6.75)). Aquatic interventions showed favorable results in balance confidence (Activities-Specific Balance Confidence: SMD=10.10; 95%CI:(2.27 to 17.93)). The results obtained in this review highlight the potential benefit of dance-based therapy in functional balance for people with Parkinson's disease, recommending its incorporation in clinical practice. Nonetheless, many aspects require clarification through further research and high-quality studies on this subject.

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“…Other long-term training studies using closed-loop visual and auditory cueing evaluated the effects of closed-loop cueing on a variety of gait parameters: gait speed [67,68,70,86,92,93], cadence [70,86], stride length [67,68,70,86], fall incidences [94], and other gait and dynamic balance measures [74,84,95] at follow-up and post-training. Only two of the long-term training studies used a wearable sensor-based, closed-loop system [86,95]. Some closed-loop training studies used augmented reality devices and game-based motion therapy for combinational cueing [72,75,77,84,96,97].…”

Section: Benefits Of Closed-loop Cueing On Gait In Pdmentioning

confidence: 99%

“…The regular practice of being upright during the training and any sustained benefits may reduce the issue of stoopness experienced by people with PD. To date, only a few closed-loop studies [70,74,86,94,95] included a randomized control trial (RCT) research design to confirm that the gait and posture improvements observed are mainly due to the presentation of cues.…”

Section: Benefits Of Closed-loop Cueing On Gait In Pdmentioning

confidence: 99%

Cueing Paradigms to Improve Gait and Posture in Parkinson’s Disease: A Narrative Review

Muthukrishnan

Abbas

Shill

et al. 2019

Sensors

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Progressive gait dysfunction is one of the primary motor symptoms in people with Parkinson's disease (PD). It is generally expressed as reduced step length and gait speed and as increased variability in step time and step length. People with PD also exhibit stooped posture which disrupts gait and impedes social interaction. The gait and posture impairments are usually resistant to the pharmacological treatment, worsen as the disease progresses, increase the likelihood of falls, and result in higher rates of hospitalization and mortality. These impairments may be caused by perceptual deficiencies (poor spatial awareness and loss of temporal rhythmicity) due to the disruptions in processing intrinsic information related to movement initiation and execution which can result in misperceptions of the actual effort required to perform a desired movement and maintain a stable posture. Consequently, people with PD often depend on external cues during execution of motor tasks. Numerous studies involving open-loop cues have shown improvements in gait and freezing of gait (FoG) in people with PD. However, the benefits of cueing may be limited, since cues are provided in a consistent/rhythmic manner irrespective of how well a person follows them. This limitation can be addressed by providing feedback in real-time to the user about performance (closed-loop cueing) which may help to improve movement patterns. Some studies that used closed-loop cueing observed improvements in gait and posture in PD, but the treadmill-based setup in a laboratory would not be accessible outside of a research setting, and the skills learned may not readily and completely transfer to overground locomotion in the community. Technologies suitable for cueing outside of laboratory environments could facilitate movement practice during daily activities at home or in the community and could strongly reinforce movement patterns and improve clinical outcomes. This narrative review presents an overview of cueing paradigms that have been utilized to improve gait and posture in people with PD and recommends development of closed-loop wearable systems that can be used at home or in the community to improve gait and posture in PD.

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Wearable Sensor-Based Biofeedback Training for Balance and Gait in Parkinson Disease: A Pilot Randomized Controlled Trial

Cited by 87 publications

References 37 publications

International Parkinson and movement disorder society evidence‐based medicine review: Update on treatments for the motor symptoms of Parkinson's disease

International Parkinson and movement disorder society evidence‐based medicine review: Update on treatments for the motor symptoms of Parkinson's disease

Additional Physical Interventions to Conventional Physical Therapy in Parkinson’s Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Cueing Paradigms to Improve Gait and Posture in Parkinson’s Disease: A Narrative Review

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