Lefaivre Shannon C, Almeida Quincy J
Sun Life Financial Movement Disorders Research and Rehabilitation Centre, Wilfrid Laurier University, Waterloo, Ontario, Canada.
Sun Life Financial Movement Disorders Research and Rehabilitation Centre, Wilfrid Laurier University, Waterloo, Ontario, Canada.
Gait Posture. 2015 Feb;41(2):630-3. doi: 10.1016/j.gaitpost.2015.01.013. Epub 2015 Jan 20.
Impaired sensory processing in Parkinson's disease (PD) has been argued to contribute to balance deficits. Exercises aimed at improving sensory feedback and body awareness have the potential to ameliorate balance deficits in PD. Recently, PD SAFEx™, a sensory and attention focused rehabilitation program, has been shown to improve motor deficits in PD, although balance control has never been evaluated. The objective of this study was to measure the effects of PD SAFEx™ on balance control in PD. Twenty-one participants with mild to moderate idiopathic PD completed 12 weeks of PD SAFEx™ training (three times/week) in a group setting. Prior to training, participants completed a pre-assessment evaluating balance in accordance with an objective, computerized test of balance (modified clinical test of sensory integration and balance (m-CTSIB) and postural stability testing (PST)) protocols. The m-CTSIB was our primary outcome measure, which allowed assessment of balance in both eyes open and closed conditions, thus enabling evaluation of specific sensory contributions to balance improvement. At post-test, a significant interaction between time of assessment and vision condition (p=.014) demonstrated that all participants significantly improved balance control, specifically when eyes were closed. Balance control did not change from pre to post with eyes open. These results provide evidence that PD SAFEx™ is effective at improving the ability to utilize proprioceptive information, resulting in improved balance control in the absence of vision. Enhancing the ability to utilize proprioception for individuals with PD is an important intermediary to improving balance deficits.
帕金森病（PD）中感觉处理受损被认为是导致平衡缺陷的原因。旨在改善感觉反馈和身体意识的锻炼有可能改善PD患者的平衡缺陷。最近，PD SAFEx™，一个专注于感觉和注意力的康复项目，已被证明可改善PD患者的运动缺陷，尽管其对平衡控制的影响从未被评估过。本研究的目的是测量PD SAFEx™对PD患者平衡控制的影响。21名轻度至中度特发性PD患者在小组环境中完成了12周的PD SAFEx™训练（每周三次）。在训练前，参与者根据客观的计算机化平衡测试（改良的感觉统合与平衡临床测试（m-CTSIB）和姿势稳定性测试（PST））方案完成了一项评估平衡的预测试。m-CTSIB是我们的主要结局指标，它可以在双眼睁开和闭合条件下评估平衡，从而能够评估特定感觉对平衡改善的贡献。在测试后，评估时间和视觉条件之间的显著交互作用（p = 0.014）表明，所有参与者的平衡控制都有显著改善，特别是在双眼闭合时。双眼睁开时，平衡控制从训练前到训练后没有变化。这些结果提供了证据，表明PD SAFEx™在提高利用本体感觉信息的能力方面是有效的，从而在没有视觉的情况下改善了平衡控制。增强PD患者利用本体感觉的能力是改善平衡缺陷的一个重要中间环节。
