Vestibular rehabilitation with computerised dynamic posturography in patients with Parkinson's disease: improving balance impairment

Disabil Rehabil. 2009;31(23):1907-16. doi: 10.1080/09638280902846384.

Abstract

Purpose: In patients with Parkinson's disease (PD), balance impairment involves considerable morbi-mortality from the numerous falls that may result. In an earlier postural study, we detected that a deteriorated processing of vestibular input is implicated. The aim of the present study is to assess the effectiveness of vestibular rehabilitation in improving overall stability in patients with PD.

Method: Out of an initial group of 45 patients with PD, we chose those presenting a high risk of falls, based on their score on the timed up and go test (TUG). Rehabilitation was performed on 10 patients using computerised dynamic posturography (CDP). Improvement was assessed using the dizziness handicap inventory (DHI), the TUG and the CDP.

Results: We found statistically significant improvement in the sensorial organisation test (SOT) and the limits of stability and rhythmic weight shift tests measured by the CDP, the DHI and the TUG. These improvements continue to be statistically significant 1 year post-treatment.

Conclusion: Vestibular rehabilitation in PD has shown to be effective in improving the activities of daily life, gait velocity and balance, as well as in reducing the risk of falls. Moreover, these benefits persist over time.

MeSH terms

  • Accidental Falls / prevention & control*
  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Biofeedback, Psychology / instrumentation*
  • Female
  • Gait Disorders, Neurologic / physiopathology*
  • Gait Disorders, Neurologic / rehabilitation*
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / physiopathology*
  • Parkinson Disease / rehabilitation*
  • Postural Balance / physiology*
  • Psychomotor Performance
  • Statistics, Nonparametric
  • Vestibular Diseases / physiopathology*
  • Vestibular Diseases / rehabilitation*