title: Does integrative medicine enhance balance in aging adults? Proof of concept for the benefit of electroacupuncture therapy in Parkinson's disease.
abstract: BACKGROUND
  Postural balance and potentially fall risk increases among older adults living with neurological diseases, especially Parkinson's disease (PD). Since conventional therapies such as levodopa or deep brain stimulation may fail to alleviate or may even worsen balance, interest is growing in evaluating alternative PD therapies.
  
  
  OBJECTIVE
  The purpose of the current study was to assess improvement in postural balance in PD patients following electroacupuncture (EA) as an alternative therapy.
  
  
  METHODS
  15 aging adults (71.2 ± 6.3 years) with idiopathic PD and 44 healthy age-matched participants (74.6 ± 6.5 years) were recruited. The PD participants were randomly assigned (at a ratio of 2:1) to an intervention (n = 10) or to a control group (n = 5). The intervention group received a 30-min EA treatment on a weekly basis for 3 weeks, while the control group received a sham treatment. Outcomes were assessed at baseline and after the final therapy. Measurements included balance assessment, specifically the ratio of medial-lateral (ML) center-of-gravity (COG) sway to anterior-posterior (AP) sway (COGML/AP) and ankle/hip sway during eyes-open, eyes-closed, and eyes-open dual-task trials, the Unified Parkinson's Disease Rating Scale (UPDRS), as well as quality of life, concerns for fall, and pain questionnaires.
  
  
  RESULTS
  No difference was observed for the assessed parameters between the intervention and the control group at baseline. After treatment, an improvement in balance performance was observed in the intervention group. Compared with the healthy population, PD patients prior to treatment had larger COGML/AP sway with more dependency on upper-body movements for maintaining balance. Following EA therapy, COGML/AP sway was reduced by 31% and ankle/hip sway increased by 46% in the different conditions (p = 0.02 for the dual-task condition). The clinical rating revealed an overall improvement (p < 0.01) in mentation, behavior, and mood (UPDRS part I, 49%), activities of daily living (UPDRS part II, 46%), and motor examination (UPDRS part III, 40%). There was a significant reduction (p < 0.02) in the specific items regarding UPDRS fall status (67%) and rigidity (48%). Changes were small and nonsignificant in the controls (p > 0.29).
  
  
  CONCLUSIONS
  This pilot study demonstrates improvement in rigidity and balance following EA. These preliminary results suggest EA could be a promising alternative treatment for balance disturbance in PD.
authors.affiliation: Interdisciplinary Consortium on Advanced Motion Performance (iCAMP) and Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, University of Arizona, Tucson, Ariz., USA.
authors.forename: Nima
authors.initials: N
authors.lastname: Toosizadeh
authors.forename: Hong
authors.initials: H
authors.lastname: Lei
authors.forename: Michael
authors.initials: M
authors.lastname: Schwenk
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Sherman
authors.forename: Esther
authors.initials: E
authors.lastname: Sternberg
authors.forename: Jane
authors.initials: J
authors.lastname: Mohler
authors.forename: Bijan
authors.initials: B
authors.lastname: Najafi
mesh_terms: D000203:Activities of Daily Living; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint; D004311:Double-Blind Method; D015671:Electroacupuncture / Q000379:methods*; D005260:Female; D006112:Gravitation; D006621:Hip Joint; D006801:Humans; D055048:Integrative Medicine; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*; D016896:Treatment Outcome