title: Robot-assisted gait training is not superior to balance training for improving postural instability in patients with mild to moderate Parkinson's disease: a single-blind randomized controlled trial.
abstract: OBJECTIVE
  The main aim was to compare robotic gait training vs. balance training for reducing postural instability in patients with Parkinson's disease. The secondary aim was to compare their effects on the level of confidence during activities of daily living requiring balance, functional mobility and severity of disease.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A total of 66 patients with Parkinson's disease at Hoehn and Yahr Stage 3.
  
  
  METHODS
  After balanced randomization, all patients received 12, 45-minute treatment sessions, three days a week, for four consecutive weeks. A group underwent robot-assisted gait training with progressive gait speed increasing and body-weight support decreasing. The other group underwent balance training aimed at improving postural reactions (self and externally induced destabilization, coordination, locomotor dexterity exercises).
  
  
  METHODS
  Patients were evaluated before, after and one month posttreatment.
  
  
  METHODS
  Berg Balance Scale.
  
  
  RESULTS
  Activities-Specific Balance Confidence Scale; Timed Up and Go Test; Unified Parkinson's Disease Rating Scale.
  
  
  RESULTS
  No significant differences were found between the groups for the Berg Balance Scale either immediately after intervention (mean score in the robotic training group 51.58 ±3.94; mean score in the balance training group 51.15 ±3.46), or one-month follow-up (mean score in the robotic training group 51.03 ±4.63; mean score in the balance training group 50.97 ±4.28). Similar results were found for all the secondary outcome measures.
  
  
  CONCLUSIONS
  Our findings indicate that robotic gait training is not superior to balance training for improving postural instability in patients with mild to moderate Parkinson's disease.
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Picelli
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Melotti
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Origano
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Neri
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Verzè
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy Neurological Rehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Marialuisa
authors.initials: M
authors.lastname: Gandolfi
authors.affiliation: Villa Melitta Rehabilitation Clinic, Bolzano, Italy.
authors.forename: Andreas
authors.initials: A
authors.lastname: Waldner
authors.affiliation: Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy Neurological Rehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy nicola.smania@univr.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Smania
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005081:Exercise Therapy / Q000295:instrumentation*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D004856:Postural Balance / Q000502:physiology*; D012371:Robotics; D012649:Self Concept; D012720:Severity of Illness Index; D016037:Single-Blind Method
keywords: Parkinson’s disease; Robot-assisted gait training; physical therapy modalities; postural balance