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Balance versus resistance training on postural control in patients with Parkinson's disease. A randomised controlled trial [with consumer summary]
Santos SMS, da Silva RA, Terra MB, Almeida IA, de Melo LB, Ferraz HB
European Journal of Physical and Rehabilitation Medicine 2017 Apr;53(2):173-183
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Evidences have shown that physiotherapy programs may improve the balance of individuals with Parkinson's disease (PD); although it is not clear which specific exercise program is better. AIM: Compare the effectiveness of balance versus resistance training on postural control measures in PD patients. DESIGN: Randomised controlled trial. SETTING: The study was conducted in a physiotherapy outpatient clinic of a university hospital. POPULATION: A total of 40 PD participants were randomly divided into two groups: balance training (BT) and resistance training (RT). METHODS: The BT group focused on balance training, functional independence and gait while the RT group performed resistance exercises emphasizing the lower limbs and trunk, both supervised by trained physiotherapists. Therapy sessions were held twice a week (at 60 minutes), totaling 24 sessions. The primary outcome was evaluated by force platform with center of pressure sway measures in different balance conditions and the secondary outcome was evaluated by Balance Evaluation Systems Test (BESTest) scale to determine the effects of the intervention on postural control. RESULTS: Significant improvement of postural control (pre 15.1 versus post 9.6 cm2) was only reported in favor of BT group (d = 1.17) for one-legged stand condition on force platform. The standardized mean difference between groups was significantly (p < 0.02), with 36% of improvement for BT versus 0.07% for RT on this condition. Significant improvement (p < 0.05) was also observed in favor of BT (in mean 3.2%) for balance gains in some BESTest scores, when compared to RT group (-0.98%). CONCLUSIONS: Postural control in Parkinson's disease is improved when training by a directional and specific balance program than a resistance training program.

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