Objective: To test the efficacy of an exergame rehabilitation programme at home to treat dopa-resistant gait and balance disorders in Parkinson’s disease (PD) patients.

Background: Gait and balance disorders with falls represent the main motor disability in Parkinson’s disease (PD) patients. With time, these motor signs become dopa-resistant and no effective treatment exists to treat them. Rehabilitation plays an important role in the PD management. Recently, exergame-based physical therapy has emerged as a motivating tool, and has been qualified as a safe, feasible and probably effective tool for rehabilitation in PD.

Method: The effects of 18 training sessions using the exergame “ToapRun” at home will be tested in 50 PD patients with dopa-resistant gait and balance disorders in a single-blinded randomised controlled trial. Twenty-five PD patients are randomly allocated to receive active treatment with whole body movements using Kinect® system to play, placing the patient in front of a screen, and 25 patients to receive non-active treatment by playing on the computer. All patients performed 2-3 sessions/week over a 6-9 weeks period. A complete clinical and neurophysiological assessment of gait and balance disorders is performed at baseline (before the first training session) and after the last training session. The primary outcome is the duration of the Stand-Walk-Sit Test (SWST), videotaped and rated by a blinded investigator. Secondary outcomes include cognitive and emotional assessments, quality of life, and feasibility/usability questionnaires relative to the exergame.

Results: To this day, 28 PD patients have been included in the study (mean age 67.3 ± 7.9 yrs; disease duration 11.3 ± 6.1 yrs), with 14 patients per group. After the last training session compared to the baseline assessment, the mean decreases in the SWST duration were 6.1 ± 24.1 sec and 0.4 ± 1.5 sec in the treated and control groups, respectively. The mean decreases in the motor parkinsonian disability and axial scores were 0.2 ± 6.9 and 2.9 ± 5.3; and 1.3 ± 2.0 and 0.2 ± 1.9, in the treated and control groups, respectively. We observed no serious adverse events.

Conclusion: These preliminary results suggest that the rehabilitation program using home exergame training may improve dopa-resistant gait and balance disorders in advanced forms of PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/serious-games-home-rehabilitation-program-to-treat-gait-and-balance-disorders-in-patients-with-parkinsons-disease-a-randomised-controlled-trial/