Beyond Conventional Therapy in Parkinson's Disease Patients: The Impact of Visual Feedback Training on Balance and Trunk Control - A Prospective Cohort Study.

Abstract

BackgroundPostural instability and impaired balance are major contributors to disability and fall risk in individuals with Parkinson's disease (PD). Technology-assisted rehabilitation based on visual biofeedback may enhance the effects of conventional physiotherapy. This study aimed to evaluate the effects of a visual feedback training program combined with conventional physiotherapy on balance, mobility, and functional independence in patients with PD.MethodsIn this prospective cohort study, 21 patients with PD (Hoehn and Yahr stages 1-3) underwent a 4-week rehabilitation program consisting of 20 sessions (60 min/session, 5 sessions/week) combining conventional physiotherapy with visual-feedback balance and trunk-control training using the ProKin 252N platform. Outcomes were assessed at baseline (T0), post-treatment (T1), 3 months (T2), and 6 months (T3). Primary outcome was the Berg Balance Scale (BBS). Secondary outcomes included the Performance-Oriented Mobility Assessment (POMA), Timed Up and Go (TUG), and Functional Independence Measure (FIM).ResultsSignificant improvements were observed after treatment in BBS (40.10 ± 8.99 vs. 43.45 ± 7.63; p < 0.001), POMA (19.00 ± 4.85 vs. 22.00 ± 3.37; p < 0.001), TUG (14.73 ± 6.10 vs. 12.84 ± 4.94 s; p = 0.010), and FIM (109.2 ± 10.75 vs. 110.2 ± 9.57; p = 0.002). Improvements were maintained at T2 and remained significantly better than baseline at T3 (BBS: 44.83 ± 7.53; Tinetti: 23.00 ± 3.38; TUG: 12.72 ± 4.47 s; FIM: 111.1 ± 8.81). Repeated-measures ANOVA demonstrated significant improvements over time for all outcomes (p < 0.001).ConclusionsVisual feedback training combined with conventional physiotherapy may improve balance, mobility, and functional independence in individuals with PD, with benefits maintained up to 6 months. Larger controlled studies are warranted to confirm these findings.