Effects of a sensory-motor orthotic on postural instability rehabilitation in Parkinson’s disease: a pilot study

BACKGROUND Proprioceptive deficits have been largely documented in PD patients, thus external sensory signals (peripheral sensory feedback) are often used to compensate the abnormalities of proprioceptive integration. This pilot study aims to evaluate the feasibility and the effectiveness of a rehabilitation-training program, combined with the use of a sensory-motor orthotic in improving balance in a small sample of PD patients. METHODS Twenty PD patients were randomly allocated into two groups: (i) the Experimental group, where participants were asked to wear a sensory-motor orthotic during the balance training program and (ii) the Control group, where subjects performed an identical training program without wearing any kind of orthotics. In all, the training program lasted 10 sessions (5 days a week for 2 weeks) and the clinical and instrumental assessments were performed at baseline, immediately after the end of the training and 4 weeks after the rehabilitative program was stopped. RESULTS All clinical outcome measures tested improved significantly at post and follow-up evaluations in both groups. Interestingly, at the end of the training, only the experimental group obtained a significant improvement in the functional reaching test (sway area - eyes closed) measured by means of stabilometric platform and this result was maintained in the follow-up evaluation. CONCLUSIONS Our preliminary results suggested that the use of a sensory-motor orthotic, in combination with a tailored balance training, is feasible and it seems to positively impact on balance performance in Parkinson's disease. TRIAL REGISTRATION EudraCT N. 003020-36 - 2013.