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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici
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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
European Journal of Physical and Rehabilitation Medicine 2016 Nov 23
Balance versus resistance training on postural control in patients with Parkinson’s disease. A randomised controlled trial
Suhaila M. SANTOS 1, Rubens A. DA SILVA 2, Marcelle B. TERRA 3, Isabela A. ALMEIDA 3, Lúcio B. DE MELO 4, Henrique B. FERRAZ 5 ✉
1 Department of Physiotherapy, Universidade Estadual de Londrina, Doctoral and Master Program in Rehabilitation Sciences (UEL/UNOPAR), Londrina, PR, Brazil; 2 Doctoral and Master Program in Rehabilitation Sciences (UEL/UNOPAR), Universidade Norte do Paraná, Londrina, PR, Brazil; 3 Master Student in Rehabilitation Sciences, Universidade Estadual de Londrina, Universidade Norte do Paraná, Londrina, PR, Brazil; 4 Department of Neurology, Universidade Estadual de Londrina, PR, Brazil; 5 Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, SP, Brazil
BACKGROUND: Evidences have shown that physiotherapy programs may improve the balance of individuals with Parkinson’s disease (PD); although it is not clear which specific exercise program is better.
AIM: Compare the effectiveness of balance versus resistance training on postural control measures in PD patients.
DESIGN: Randomised controlled trial.
SETTING: The study was conducted in a physiotherapy outpatient clinic of a university hospital.
POPULATION: A total of 40 PD participants were randomly divided into two groups: balance training (BT) and resistance training (RT).
METHODS: The BT group focused on balance training, functional independence and gait while the RT group performed resistance exercises emphasizing the lower limbs and trunk, both supervised by trained physiotherapists. Therapy sessions were held twice a week (at 60 minutes), totaling 24 sessions. The primary outcome was evaluated by force platform with center of pressure sway measures in different balance conditions and the secondary outcome was evaluated by Balance Evaluation Systems Test (BESTest) scale to determine the effects of the intervention on postural control.
RESULTS: Significant improvement of postural control (pre = 15.1 vs post = 9.6 cm2) was only reported in favor of BT group (d = 1.17) for one-legged stand condition on force platform. The standardized mean difference between groups was significantly (P < 0.02), with 36% of improvement for BT vs. 0.07% for RT on this condition. Significant improvement (P < 0.05) was also observed in favor of BT (in mean 3.2%) for balance gains in some BESTest scores, when compared to RT group (-0.98%).
CONCLUSIONS: Postural control in Parkinson's disease is improved when training by a directional and specific balance program than a resistance training program.
CLINICAL REHABILITATION IMPACT: Balance training is superior to resistance training in regard to improving postural control of individuals with PD. Gold standard instruments (high in cost and difficult to access) were used to assess balance, as well as scales with clinical applicability (low cost, easily acceptable, applicable and valid), which can guide the management of physiotherapists both in their decision-making and in clinical practice.