Blindfolded Balance Training in Patients with Parkinson’s Disease: A Sensory-Motor Strategy to Improve the Gait

Abstract

Aim. Recent evidence suggested that the use of treadmill training may improve gait parameters. Visual deprivation could engage alternative sensory strategies to control dynamic equilibrium and stabilize gait based on vestibulospinal reflexes (VSR). We aimed to investigate the efficacy of a blindfolded balance training (BBT) in the improvement of stride phase percentage reliable gait parameters in patients with Parkinson's Disease (PD) compared to patients treated with standard physical therapy (PT). Methods. Thirty PD patients were randomized in two groups of 15 patients, one group treated with BBT during two weeks and another group treated with standard PT during eight weeks. We evaluated gait parameters before and after BBT and PT interventions, in terms of double stance, swing, and stance phase percentage. Results. BBT induced an improvement of double stance phase as revealed (decreased percentage of double stance phase during the gait cycle) in comparison to PT. The other gait parameters swing and stance phase did not differ between the two groups. Discussion. These results support the introduction of complementary rehabilitative strategies based on sensory-motor stimulation in the traditional PD patient's rehabilitation. Further studies are needed to investigate the neurophysiological circuits and mechanism underlying clinical and motor modifications.

Proprioceptive Focal Stimulation (Equistasi®) May Improve the Quality of Gait in Middle-Moderate Parkinson's Disease Patients. Double-Blind, Double-Dummy, Randomized, Crossover, Italian Multicentric Study

“…Furthermore, the supplementary motor cortex is known to play an important role in connecting the sensory and the motor system (28) and it is also involved in the initiation of the anticipatory postural adjustments expressed in the DST (29). From a clinical point of view studies on rehabilitation trials based on exercises that stimulate the sensorimotor system such as the Blindfolder Balance Training (BBT) (1), recording TMS with and without BBT showed amelioration in Double Stance Support and modification of parameters of TMS (30) only in PD group with performed BBT. These findings confirm the important role of the indirect basal ganglia pathways on PD.…”

“…PD is a movement disorder, but it involves many different pathways of the Central Nervous System (i.e., Vestibular system or CM/PF complex pathways). Gait disorders, balance impairment, falls, and fall-related injuries have frequently reported by PD patients (1). Indeed, patients with PD demonstrate impaired ability to walk (2, 3) and to change direction (4).…”

Vestibular Deficits in Neurodegenerative Disorders: Balance, Dizziness, and Spatial Disorientation

“…Similarly, targeted vestibular rehabilitation and therapy in PD has received attention, demonstrating improved postural control and balance performance ( 105 – 108 ). Stimulation of the vestibulospinal tract through proprioceptive disturbance and visual suppression improved double stance gait performance in patients with PD compared to those receiving standard physiotherapy ( 109 ). Moreover, in a single patient study, repeated caloric stimulation produced improvement in assessment scores for motor and non-motor symptoms of PD, which was sustained at 5-month follow-up ( 110 ).…”

The effects of aquatic therapy during post-acute neurorehabilitation in patients with severe traumatic brain injury: a preliminary randomized controlled trial

“…Posture and locomotion are complex multi-factorial systems in which motor, sensory, and cognitive components interact, ensuring postural control in both static and dynamic conditions (17,18). The weighting of the sensory inputs likely depends on environmental conditions and it changes according to the motor task in which the person is involved (19)(20)(21).…”