The effects of a balance and strength training program on equilibrium in Parkinsonism: A preliminary study

Abstract

The purpose of this study was to determine if a balance and strength training program could improve equilibrium and strength in persons with stage I-III Parkinsonism. Subjects were pre-tested on strength and balance (EquiTest) and randomized into either a treatment or a control group. The treatment subjects participated in 10 weeks of lower limb strength training and balance exercises designed to challenge a stable posture and increase limits of stability. Both groups were then posttested on balance, knee flexion, knee extension, and ankle inversion strength. Subjects who received strength and balance training demonstrated significantly improved equilibrium and modest gains in knee flexion and extension strength, while the control group showed no improvement in conditions of destabilizing balance environments and significant declines in strength. Results indicate that 10 weeks of balance and strength training lead to improved equilibrium by producing positive changes in two different control mechanisms. One, training altered the ability to control the motor system when vestibular cues had to be the primary source of reliable feedback; and two, training helped subjects to override faulty proprioceptive feedback and utilize reliable visual or vestibular cues.

The effectiveness of exercise interventions for people with Parkinson's disease: A systematic review and meta‐analysis

“…Muscle strength was reported in four studies. 29,33,35,36 A significant improvement in leg muscle strength was reported by Hirsch et al 35 and Toole et al 33 Palmer et al 29 did not report between group differences although did report some improvements in grip strength in both the karate and stretching groups.…”

“…Only two studies 38,41 reported power and sample size calculations. While two studies did not clearly report participant selection criteria, 33,36 the criteria reported in the other studies were varied, although all included a diagnosis of PD and being medically stable. Similarly, participant exclusion criteria also varied between the studies.…”

“…Only three papers explicitly reported concealment of randomization 38,40,41 and we cannot discount the possibility of selection bias in the other papers. With regards to assessor blinding, all but four studies [33][34][35][36] reported that assessors were blinded to participant allocation. Ashburn et al, 41 however, reported that by the six month follow up assessment the assessor was aware of allocation for 39% of those in the intervention group and 17% of the controls.…”

“…The characteristics of included studies are described in studies reported in this review. The minimum number of participants in a study was 11 33 and the maximum was 142. 41 Of the studies reporting the sex of participants 282/423 (67%) were male.…”

“…Five studies 32,33,35,36,41 reported balance as an outcome using three tools (Berg Balance Scale, Functional Reach and Sensory Orientation Test-SOT). A significant improvement in balance was reported in four of the five of the studies; however, Toole et al 36 reported a favorable improvement on the SOT but not on the Berg Balance Scale, and Ashburn et al 41 found an improvement in functional reach but not in the Berg Balance Scale.…”