The findings from a phase 2 randomized controlled trial newly published in the European Journal of Neurology demonstrated efficacy of a home-based, full-body movement, active training using tailored exergaming designed for patients with Parkinson disease (PD) who had medically refractory gait and balance disorders. These findings suggest home-based training using a tailored exergame can be performed safely by patients with PD and could improve gait and balance disorders in this population.1
Following 18 training sessions, investigators did not observe significant difference in Stand-Walk-Sit Test (SWST) score change between the active group (n = 25) and control group (n = 25) (active group, –3.71 s [SD, 18.06]; control group, –0.71s [SD, 3.41]; P = .61). Some 32% of patients in the active and 8% in the control group were considered responders to the training program, defined as a SWST duration change at least 2 s (P = .03). Notably, the clinical severity of gait and balance disorders also significantly decreased following active training, with a between-group difference in favor of the active training (P = .0082).
Top Clinical Takeaways
- Home-based, full-body movement exergaming shows promise in improving clinical gait and balance disorders in patients with PD, despite no significant changes in functional mobility observed.
- The study's limitations—including participant dropouts and the inability to compare exergaming with no training or usual care—highlight challenges and areas for future research in PD rehabilitation.
- Although not conclusive, the findings contribute valuable insights into the potential effectiveness of exergaming in enhancing patients' adherence and efficacy in rehabilitation programs for PD.
“We observed no significant difference in functional mobility (the SWST duration) between active full-body movement training and control gaming. However, active exergaming training did improve clinical gait and balance disorders scores and postural gait kinetics,” senior author Marie-Laure Welter, MD, PhD, HDR, a neurologist at Institut National de la Santé et de la Recherche Médicale, in Paris, France, and colleagues wrote.1 “The control group showed no changes in motor signs, but improvement in quality of life and anxiety. The exergaming training was well received and tolerated.”
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Investigators recruited 50 patients with PD who had dopa-resistant gait and/or balance disorders. Patients were randomly assigned in a 1:1 ratio to receive training sessions at home by playing a tailored exergame with full-body movements using a motion capture system for the active group or by playing the same game with the computer's keyboard for the control group. The researchers assessed the difference between-group difference in the SWST duration change after training as the primary end point, and the secondary outcomes assessed included parkinsonian clinical scales, gait recordings, and safety.
