Effects of Virtual Reality Balance Training on Postural Stability and Dual-task Performance in Patients with Parkinson’s Disease
Date Issued
2008
Date
2008
Author(s)
Yen, Chang-Yi
Abstract
Background: Postural instability is common in subjects with Parkinson’s disease (PD), which makes it keen to fall and suffer from unnecessary injury. Previous studies demonstrated that postural stability is the results of interaction of sensory, motor and cognitive system. Purpose: In this study, we tried to investigate short tem and long term effects of virtual reality (VR) balance training on sensory, motor and cognitive domains of postural stability, while compared with conventional balance (CB) training and untrained control group (CG). Method: In this single blind randomized control trial, we recruited 42 PD patients (age: 70.6±6.3y/o；Hoehn and Yahr Stage:2~3)，and allocated them into VR group(n=14), CB group(n=14) and CG group (n=14) by stratified randomization. Both training groups received 6 weeks intervention (2sessions/week, 30 min./session) but the control group did not receive any kind of therapy. Each subject received assessments of postural stability before and after training period and at 4 weeks follow-up, including Sensory Organization test (SOT) with dual task paradigm and Limits of Stability test (LOS) of SMART balance master (Neurocom®), Timed up and go (TUG) and Activities-specific Balance Confidence scale (ABC) assessment. The 3-way mixed ANOVA (3 Groups x 3 Times x 2 Tasks) was used to test our hypotheses with intention to treat analysis. Results: (1) VR training significantly increased equilibrium score (ES) of SOT 6 either in single or dual task condition, and CB training significantly increased equilibrium score (ES) of SOT 5 either in single or dual task condition. Furthermore, secondary task significantly deteriorated ES of SOT 6 in CB group, but not for VR group. The improvements tended to be maintained for at least 4 weeks; (2) VR training significantly enhanced movement velocity (MVL) in forward direction, as well as MVL and maximal excursion (ME) in backward direction. MVL was increased continuously during 4 weeks follow-up, and MVL and ME in backward tended to be maintained; (3) both training programs did not increased ABC scores; (4) VR training did not increase walking speed, but CB training could significantly increase walking speed and tended to maintain the improvement for at least 4 weeks. Conclusion: VR training could improve static and dynamic balance and attenuate deteriorated effect of dual task on postural stability. Therefore, we suggested VR balance training could be added into rehabilitation programs to improve postural stability in PD patients.
Subjects
Parkinson’s disease
Virtual reality
Postural stability
Dual task
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