Robot-assisted gait training is not superior to balance training for improving postural instability in patients with mild to moderate Parkinson’s disease: a single-blind randomized controlled trial

摘要

OBJECTIVE: The main aim was to compare robotic gait training vs. balance training for reducing postural instability in patients with Parkinson's disease. The secondary aim was to compare their effects on the level of confidence during activities of daily living requiring balance, functional mobility and severity of disease. DESIGN: Randomized controlled trial. SETTING: University hospital. SUBJECTS: A total of 66 patients with Parkinson's disease at Hoehn and Yahr Stage 3. INTERVENTION: After balanced randomization, all patients received 12, 45-minute treatment sessions, three days a week, for four consecutive weeks. A group underwent robot-assisted gait training with progressive gait speed increasing and body-weight support decreasing. The other group underwent balance training aimed at improving postural reactions (self and externally induced destabilization, coordination, locomotor dexterity exercises). MAIN MEASURES: Patients were evaluated before, after and one month posttreatment. MAIN OUTCOME MEASURE: Berg Balance Scale. SECONDARY OUTCOMES: Activities-Specific Balance Confidence Scale; Timed Up and Go Test; Unified Parkinson's Disease Rating Scale. RESULTS: No significant differences were found between the groups for the Berg Balance Scale either immediately after intervention (mean score in the robotic training group 51.58 ±3.94; mean score in the balance training group 51.15 ±3.46), or one-month follow-up (mean score in the robotic training group 51.03 ±4.63; mean score in the balance training group 50.97 ±4.28). Similar results were found for all the secondary outcome measures. CONCLUSIONS: Our findings indicate that robotic gait training is not superior to balance training for improving postural instability in patients with mild to moderate Parkinson's disease.