Technology-assisted balance and gait training rreduces falls in patients with Parkinson's disease: A randomized controlled trial with 12-month follow-up

Objective. To examine the effects of technology-assisted balance and gait training on reducing falls in patients with Parkinson's disease (PD). Methods. Eligible subjects were randomly allocated to an experimental group given technology-assisted balance and gait training (BAL, n = 26) and an active control group undertaking strengthening exercises (CON, n = 25). The training in each group lasted for 3 months. The number of fallers and fall rate were used as primary outcomes, and single-leg-stance-time, latency of postural response to perturbation, self-selected gait velocity, and stride length as secondary outcomes. Fall incidence was recorded over 15 months after the baseline assessment (Pre). Other tests were performed at Pre, after 3-month intervention (Post3m), at 3 months (Post6m), and 12 months (Post15m) after treatment completion. Results. Forty-five subjects who completed the 3-month training were included in the data analysis. There were fewer fallers in the BAL than in the CON group at Post3m, Post6m, and Post15m (P <.05). In addition, the BAL group had lower fall rate than the CON group at Post3m and Post6m (incidence rate ratio: 0.111-0.188, P <.05), and marginally so at Post15m (incidence rate ratio: 0.407, P =.057). Compared with the CON subjects, the BAL subjects demonstrated greater reduction in the postural response latency and increase in the stride length against baseline at each assessment interval (P <.05), and marginally more increases of single-leg-stance-time at Post3m (P =.064), Post6m (P =.041) and Post15m (P =.087). Conclusions. Our positive findings provide evidence for the clinical use of technology-assisted balance and gait training in reducing falls in people with PD.