Objective: To identify whether proprioceptive function in Parkinson’s disease (PD) can be enhanced by specialized visuomotor training that emphasizes precise movements and determine if such proprioceptive improvements lead to improved motor performance.

Background: Recent research shows that sensorimotor training that challenges proprioceptive system improves proprioceptive acuity and translates to improved motor function. It is well established that PD patients along with motor deficits experience proprioceptive impairments. It is unknown whether proprioceptive function can be enhanced in PD and to what extent improved proprioceptive function translates to improved motor performance. To fill this knowledge gap, we administered a sensorimotor training to PD patients using a wrist robotic device coupled with a real-time virtual visual environment.

Methods: 5 participants diagnosed with PD (mean age = 61.8 yrs; mean disease duration = 2.5 yrs) were tested in their ON medication state. Training involved tilting a virtual table to position a virtual ball on a target by making precise small amplitude wrist flexion/extension movements. With increasing proficiency, task difficulty increased by adjusting the responsiveness of the virtual ball. Wrist position sense acuity and spatial precision of an untrained goal-directed wrist movement were assessed without vision before and after. Wrist position sense discrimination thresholds were obtained using controlled robotic motion to passively rotate the wrist joint. Mean movement precision error was determined using the absolute angular difference between passively presented target of 15° wrist flexion and subsequent active movement to the target by the participant.

Results: All participants showed improvements in wrist proprioceptive thresholds (mean: pre/post = 1.6° / 1.1°). Wrist movement precision improved in 4/5 participants (mean: pre/post = 2.3° / 1.6°).

Conclusions: Wrist proprioceptive function improves after brief specialized visuomotor training in PD patients. Movement precision in an untrained motor task also improved on average by 30% in most participants, indicating that such sensory-based training directly benefits motor function. These initial findings are promising and suggest that somatosensory-based training may enhance sensorimotor function in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/proprioceptive-training-as-a-means-to-enhance-sensorimotor-function-in-parkinsons-disease/