Tramontano M, Bonnì S, Martino Cinnera A, Marchetti F, Caltagirone C, Koch G, Peppe A
IRCCS Santa Lucia Foundation, 00179 Rome, Italy.
Non-Invasive Brain Stimulation Unit, IRCCS Santa Lucia Foundation, Rome, Italy.
Parkinsons Dis. 2016;2016:7536862. doi: 10.1155/2016/7536862. Epub 2016 Feb 9.
Aim. Recent evidence suggested that the use of treadmill training may improve gait parameters. Visual deprivation could engage alternative sensory strategies to control dynamic equilibrium and stabilize gait based on vestibulospinal reflexes (VSR). We aimed to investigate the efficacy of a blindfolded balance training (BBT) in the improvement of stride phase percentage reliable gait parameters in patients with Parkinson's Disease (PD) compared to patients treated with standard physical therapy (PT). Methods. Thirty PD patients were randomized in two groups of 15 patients, one group treated with BBT during two weeks and another group treated with standard PT during eight weeks. We evaluated gait parameters before and after BBT and PT interventions, in terms of double stance, swing, and stance phase percentage. Results. BBT induced an improvement of double stance phase as revealed (decreased percentage of double stance phase during the gait cycle) in comparison to PT. The other gait parameters swing and stance phase did not differ between the two groups. Discussion. These results support the introduction of complementary rehabilitative strategies based on sensory-motor stimulation in the traditional PD patient's rehabilitation. Further studies are needed to investigate the neurophysiological circuits and mechanism underlying clinical and motor modifications.
目的。近期证据表明，使用跑步机训练可能会改善步态参数。视觉剥夺可促使基于前庭脊髓反射（VSR）采用替代感觉策略来控制动态平衡并稳定步态。我们旨在研究与接受标准物理治疗（PT）的患者相比，蒙眼平衡训练（BBT）对帕金森病（PD）患者步幅阶段百分比可靠步态参数改善的疗效。方法。30例PD患者被随机分为两组，每组15例，一组接受为期两周的BBT治疗，另一组接受为期八周的标准PT治疗。我们在BBT和PT干预前后，从双支撑、摆动和支撑阶段百分比方面评估步态参数。结果。与PT相比，BBT使双支撑阶段得到改善（步态周期中双支撑阶段百分比降低）。两组之间的其他步态参数摆动和支撑阶段无差异。讨论。这些结果支持在传统PD患者康复中引入基于感觉运动刺激的补充康复策略。需要进一步研究来探究临床和运动改变背后的神经生理回路及机制。
