title: Effects of augmented visual feedback during balance training in Parkinson's disease: a pilot randomized clinical trial.
abstract: BACKGROUND
  Balance training has been demonstrated to improve postural control in patients with Parkinson's disease (PD). The objective of this pilot randomized clinical trial was to investigate whether a balance training program using augmented visual feedback is feasible, safe, and more effective than conventional balance training in improving postural control in patients with PD.
  
  
  METHODS
  Thirty-three patients with idiopathic PD participated in a five-week training program consisting of ten group treatment sessions of 60 min. Participants were randomly allocated to (1) an experimental group who trained on workstations consisting of interactive balance games with explicit augmented visual feedback (VFT), or (2) a control group receiving conventional training. Standing balance, gait, and health status were assessed at entry, at six weeks, and at twelve weeks follow-up.
  
  
  RESULTS
  Sixteen patients were allocated to the control group and seventeen to the experimental group. The program was feasible to apply and took place without adverse events. Change scores for all balance measures favored VFT, but the change in the primary outcome measure, i.e. the Functional Reach test, did not differ between groups (t(28) = -0.116, p = .908). No other differences between groups were statistically significant.
  
  
  CONCLUSIONS
  VFT proved to be a feasible and safe approach to balance therapy for patients with PD. In this proof-of-concept study VFT was not superior over conventional balance training although observed trends mostly favored VFT. These trends approached clinical relevance only in few cases: increasing the training load and further optimization of VFT may strengthen this effect.
  
  
  BACKGROUND
  Controlled Trials, ISRCTN47046299.
authors.affiliation: MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands. Electronic address: m.r.c.vanden.heuvel@vu.nl.
authors.forename: Maarten R C
authors.initials: MR
authors.lastname: van den Heuvel
authors.affiliation: MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands; Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, De Boelelaan 1118, 1007 MB Amsterdam, The Netherlands; Department of Neurorehabilitation, Reade Center for Rehabilitation and Rheumatology, Amsterdam, The Netherlands.
authors.forename: Gert
authors.initials: G
authors.lastname: Kwakkel
authors.affiliation: MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands; Brunel University, School of Sport and Education, Uxbridge, UK.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Beek
authors.affiliation: Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
authors.forename: Henk W
authors.initials: HW
authors.lastname: Berendse
authors.affiliation: MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands.
authors.forename: Andreas
authors.initials: A
authors.lastname: Daffertshofer
authors.affiliation: MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands; Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, De Boelelaan 1118, 1007 MB Amsterdam, The Netherlands.
authors.forename: Erwin E H
authors.initials: EE
authors.lastname: van Wegen
mesh_terms: D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D056228:Feedback, Sensory / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology / Q000534:rehabilitation*; D004856:Postural Balance / Q000502:physiology*; D016896:Treatment Outcome
keywords: Balance training; Parkinson's disease; Physical therapy; Serious gaming; Visual feedback