Content » Vol 53, Issue 2

Original report

Effectiveness of robotic balance training on postural instability in patients with mild Parkinson's disease: A pilot, single blind, randomized controlled trial

Stefania Spina, Salvatore Facciorusso, Nicoletta Cinone, Raffaella Armiento, Alessandro Picelli, Christian Avvantaggiato, Chiara Ciritella, Pietro Fiore, Andrea Santamato
Physical Medicine and Rehabilitation Section, Policlinico Riuniti, University of Foggia, Foggia, Italy.
DOI: 10.2340/16501977-2793


Objective: To examine whether tailored robotic platform training could improve postural stability compared with conventional balance treatment in patients with mild Parkinson’s disease. 
Design: Randomized single-blind pilot study.
Subjects: Twenty-two patients with mild Parkinson’s disease (Hoehn & Yahr scale; H&Y 1–2).
Methods: Patients were randomly assigned to an experimental group for robotic balance training and to a control group for conventional balance training. Each patient received 20 treatments (45 min/session, 5 times/week). Blinded evaluations were conducted before and after the treatment and 1 month post-treatment. Primary outcome measures were Mini BESTest, and Berg Balance Scale; secondary outcome measures were 10-Meter Walk Test, Five Times Sit to Stand Test, and Parkinson’s Disease Questionnaire 39.
Results: Primary outcome measures in patients in both the experimental and control groups improved significantly after the balance treatment. Similar results were found for all the secondary outcome measures. The experimental group performed significantly better than the control group at both post-intervention and follow-up evaluation in the primary outcomes (p < 0.05). No significant differences be-tween groups were found in secondary outcomes.
Conclusion: Robot-assisted balance training may be a promising tool to improve postural stability in patients with mild Parkinson’s disease.

Lay Abstract

More than 10 million people worldwide are living with Parkinson’s disease. Parkinson’s disease is a slowly progressive neurodegenerative disorder that leads to balance problems. Balance is a major concern in patients with Parkinson’s disease, and shows poor response to pharmacological treatment. It is known that exercise and physio-therapy can help. The best approach is to start exercising at the early stages of the disease with personalized rehabil-itation treatment. This study explored the effec-tiveness of a new robotic platform treatment on balance compared with the conventional approach. Both trainings were found to improve balance, walking and quality of life. However, robotic balance training could have a major impact. The robotic device enables the training to be intense, fun, task-oriented, challenging and personalized, enhanc-ing motor learning and neuroplasticity. This advance in rehabil-itation technology could help to meet the challenges presented by Parkinson’s disease.


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