title: Emerging therapies for gait disability and balance impairment: promises and pitfalls.
abstract: Therapeutic management of gait and balance impairment during aging and neurodegeneration has long been a neglected topic. This has changed considerably during recent years, for several reasons: (1) an increasing recognition that gait and balance deficits are among the most relevant determinants of an impaired quality of life and increased mortality for affected individuals; (2) the arrival of new technology, which has allowed for new insights into the anatomy and functional (dis)integrity of gait and balance circuits; and (3) based in part on these improved insights, the development of new, more specific treatment strategies in the field of pharmacotherapy, deep brain surgery, and physiotherapy. The initial experience with these emerging treatments is encouraging, although much work remains to be done. The objective of this narrative review is to discuss several promising developments in the field of gait and balance treatment. We also address several pitfalls that can potentially hinder a fast and efficient continuation of this vital progress. Important issues that should be considered in future research include a clear differentiation between gait and balance as two distinctive targets for treatment and recognition of compensatory mechanisms as a separate target for therapeutic intervention.
authors.affiliation: Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases (DNZE), Tübingen, Germany.
authors.forename: Walter
authors.initials: W
authors.lastname: Maetzler
authors.forename: Freek
authors.initials: F
authors.lastname: Nieuwhof
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Hasmann
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
mesh_terms: D004632:Emergency Medical Services / Q000379:methods*; D020233:Gait Disorders, Neurologic / Q000523:psychology / Q000628:therapy*; D006801:Humans; D004856:Postural Balance / Q000502:physiology*; D011788:Quality of Life; D012678:Sensation Disorders / Q000523:psychology / Q000628:therapy*
keywords: Parkinson's disease; ageing; falls; pharmacotherapy; treatment