Biofeedback Endurance Training for Gait Rehabilitation in Parkinson’s Disease: a Non-Randomized Controlled Study

Abstract

INTRODUCTION. Parkinson’s disease is a disease with the highest rates of disability growth in the neurodegenerative pathology group, with the leading motor symptom — impaired walking and an increased risk of falling. There is evidence that Parkinson’s disease preserves stability for cycling. The issue of extending the effects of cycling training to daily activity, including walking, remains unclear. AIM. To evaluate the effect of a course of endurance training on a cycle ergometer with biofeedback (BFB) on a walking ability of a patient with Parkinson’s disease. MATERIALS AND METHODS. A total of 69 patients with stages 2–3 Parkinson’s disease according to the Hoehn and Yahr Rating Scale were included in the study, group 1: 34 people (60.05 ± 7.07 years) and group 2: 35 patients (61.75 ± 7.53 years). The patients were examined — anamnesis collection: duration of Parkinson disease, presence of arterial hypertension (AH), sports history, medication, assessment of systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), “6-minute walk” test (6MWT), motor function according to the MDS UPDRS scale — part III. The patients of group 1 had daily exercises on a digital bicycle ergometer with BOS for 10 days, the patients of group 2 — therapeutic gymnastics. The therapy was assessed by repeated 6MWT. RESULTS AND DISCUSSION. The Parkinson’s disease duration was longer in the patients of group 1. Concomitant hypertension was in 20 (57 %) patients of group 1 and 16 (47 %) patients of group 2 (p 0.05). 11 people of group 1 and 5 of group 2 had a sports history (p = 0.07). The indicators of SBP and DBP of groups 1 and 2 had normal values during the examination. BMI in both groups corresponded to excess body weight. Patients had risk factors of the modern world: hypertension and overweight. Motor disorders according to the MDS UPDRS — Part III scale were greater in group 1. Despite having serious motor impairments in group 1, after the therapy, the patients demonstrated an increase in the distance traveled in 6 minutes (392.18 ± 96.3 m vs. 476.43 ± 108.08 m; p 0.05), while no changes were found in group 2. CONCLUSION. BOS endurance training on a cycle ergometer is effective for walking rehabilitation of Parkinson’s disease patients.