Effects of Exercise Therapy on Postural Instability in Parkinson Disease

Abstract

Exercise therapies specifically addressing balance dysfunction are an important treatment option for improving postural stability in persons with PD. Future studies should investigate sustainability of the short-term effects and establish the dose-response relationship of balance training in persons with PD.Video abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A121).

Factors Contributing to Perceived Walking Difficulties in People with Parkinson’s Disease

“…According to recommendations [63,64], strength training should be combined with training that includes other components such as balance. This is further underlined by the fact that postural instability contributed independently to perceived walking difficulties in this study.…”

A New Perspective for Parkinson’s Disease: Circadian Rhythm

“…For example, voluntary wheel-running could affect physiological circadian rhythms and delay the phase of peripheral Per2 expression [113]. Also, a metaanalysis showed that physical exercises including Argentine Tango and Tai Ji Quan may be appropriate choices for postural instability therapy in PD [114][115][116]. However, few exploratory studies have examined the effect of physical exercise on circadian systems in PD patients.…”

The Effect of Heel Lifts on Postural Stability in Individuals with Parkinson’s Disease

“…Pharmacological research suggests that poor balance in this population is due to malfunctioning afferent sensory integration and decreased 5,6 efferent neuromuscular signals in the central nervous system (CNS). However there is also evidence that balance can worsen with these pharmacological interventions, suggesting 2,7 there are other contributors to fall risk in this population.…”

“…Dopamine is an important neurotransmitter for multiple body functions including movement proficiency. Due to the lack of dopamine, people with PD commonly present with four primary motor symptoms: resting 2,3 tremors, bradykinesia, rigidity, and postural instability. While extensive research is aimed at treating tremors, bradykinesia, and rigidity, little research has analyzed the relationship between posture and stability.…”

“…This study showed accommodating PF contractures with heel lift intervention significantly improved postural alignment and perceived stability, but decreased participants' functional reach. 2 postural instability within 2 years of diagnosis. Pharmacological research suggests that poor balance in this population is due to malfunctioning afferent sensory integration and decreased 5,6 efferent neuromuscular signals in the central nervous system (CNS).…”