Effects of a core stabilization training program on balance ability in persons with Parkinson’s disease: a randomized controlled trial

Abstract

Objective: To explore the effects of an eight-week core stability program on balance ability in persons with Parkinson’s disease. Design: Randomized controlled trial. Setting: A local Parkinson’s association. Subjects: A total of 44 participants with a clinical diagnosis of Parkinson’s disease were randomly assigned to an experimental ( n = 22) or control group ( n = 22). Intervention: The experimental group received 24 sessions of core training, while the control group received an intervention including active joint mobilization, muscle stretching, and motor coordination exercises. Main measures: The primary outcome measure was dynamic balance evaluated using the Mini-Balance Evaluation Systems Test. Secondary outcomes included the balance confidence assessed with the Activities-specific Balance Confidence Scale and standing balance assessed by the maximal excursion of center of pressure during the Modified Clinical Test of Sensory Interaction on Balance and the Limits of Stability test. Results: After treatment, a significant between-group improvement in dynamic balance was observed in the experimental group compared to the control group (change, 2.75 ± 1.80 vs 0.38 ± 2.15, P = 0.002). The experimental group also showed a significant improvement in confidence (change, 16.48 ± 16.21 vs 3.05 ± 13.53, P = 0.047) and maximal excursion of center of pressure in forward (change, 0.86 ± 1.89 cm vs 0.17 ± 0.26 cm, P = 0.048), left (change, 0.88 ± 2.63 cm vs 0.07 ± 0.48 cm, P = 0.010), and right (change, 1.63 ± 2.82 cm vs 0.05 ± 0.17 cm, P = 0.046) directions of limits of stability compared to the control group. Conclusion: A program based on core stability in comparison with non-specific exercise benefits dynamic balance and confidence and increases center of mass excursion in patients with Parkinson’s disease.

Physical Therapist Management of Parkinson Disease: A Clinical Practice Guideline From the American Physical Therapy Association

“…Two high-quality studies 92 , 97 compared core strengthening with conventional physical therapy, with conflicting findings related to balance. Therefore, no definitive statement can be made.…”

Deep brain stimulation in the subthalamic nuclei alters postural alignment and adaptation in Parkinson’s disease

“…In PD however there is impaired integration of proprioception [ 9 , 10 ] which may alter the perception of an abnormal trunk position. To compensate for this, postural control in PD becomes increasingly dependent upon trunk muscle strength [ 11 ] and visual information [ 12 ]. The latter reflects increased visual dependency, which involves a shift to more reliable sensory cues, i.e., to visual afferents.…”

Which Exercise Interventions Can Most Effectively Improve Reactive Balance in Older Adults? A Systematic Review and Network Meta-Analysis

“…A total of 7,394 records were retrieved from electronic databases and two additional records were obtained from other sources, of which 384 studies remained after removing duplicates and screening titles and abstracts. Based on the full-text screening, 46 records fulfilled the eligibility criteria and thus were included for qualitative analysis (i.e., systematic review), whereas seven studies were additionally excluded from the quantitative analysis (i.e., network meta-analysis) due to data not being reported and not irretrievable (Kim and Lockhart, 2010 ; Okubo et al, 2019 ; Wang et al, 2019 ), exercise types not included in the network (Allin et al, 2020 ; Cabrera-Martos et al, 2020 ), exercise intervention included in only one trial (Lacroix et al, 2016 ), and no continuous data reported (Beling and Roller, 2009 ), resulting in a total of 39 studies for NMA. The schematic flow chart for the selection process is presented in Figure 1 , and all included studies are listed in Supplementary Table 1 .…”

“…Data from a total of 39 studies ( n = 1388, age = 71.5 ± 3.9 years) were included in the NMA. Of the 15 exercise types reported in Table 1 , 14 types were included in the NMA as functional training was implemented in only one study and consequently included in a disconnected network (Cabrera-Martos et al, 2020 ). There were 11 multi-arm trials, and three of which consisted of two groups sharing the same exercise type and the third group with another type (Hatzitaki et al, 2009 ; Ni et al, 2014 ; Lacroix et al, 2016 ); thus, data in these two groups were combined into a single group.…”