Core stability and unstable surface training in parkinson's desease: a longitudinal study

Aim: The aim of this study was to verify as a resistance training for core muscles compared with a proprioceptive training using unstable surface could modify force production, body balance, joint mobility and gait cycle in subjects with PD. Methods: To participate in this study 8 subjects with PD (6 men and 2 women age 73±9 years; weight 69±16 kg; height 164±13 cm and a disability score according to Hoehn e Yahr scale 2±1) were recruited. All subjects were able to walk by thereselves and they did not need to be helped while walking. The sample was tailed in two small groups composed by 4 people. The experimental period was 12 months long, divided in 3 part. In the first part (first 4 months) one group performed the core stability schedule (CSG) while the other one practiced the unstable surface training program (USG). Both groups inverted their workout in the last part of the study (last 4 months). In the 4 central months subjects did not perform any particular physical activities. The study was counter-balanced so both groups performed two different training schedules. Both unstable surface and core stability involved two 60 minutes sessions per week. Subjects were tested using sit and react test, postural stability P-Walk (BTS Bioengineering, Milano, Italy), Spinal Mouse® test (Idiag, Volketswil, Switzerland), sit to stand test and gait analysis G-Walk (BTS Bioengineering, Milano, Italy). Results: The data showed the following results in the USG group: stride length (Wilcoxon test, p<0,05, -3%) Sit to stand flight time (Wilcoxon test, p<0,05, +27%). In CSG the results showed: cadence (Wilcoxon test, p<0,01, +3%), speed ( Wilcoxon test, p<0,05, +5%), left stride duration (Wilcoxon test, p<0,05,-3%) gait cycle duration (Wilcoxon test, p=0,06, -2%). Conclusions: USG trend was to perform movements slowly because of they improved dynamic balance ability, while CSG was better to manage dynamic motor patterns. This data confirm what was previous done highlighting the positive effects of these training schedules. Finally, we suggest to alternate both these training protocols during the same workout, to take advantages to both methodology in the therapy program in PD. References 1. Crizzle A, Newhouse I. Physical Exercise Beneficial for Persons with Parkinson’s Disease, Clin J Sport Med 2006;16:422-425 2. Kuroda K, Tatara K, Takatorige T, Shinsho F. effect of physical exercise on mortality in patients with Parkinson’s disease. Acta Neurol Scand 1992, 86: 55-59 3. Hoehn M, Yahr M. Parkinsonism: onset, progression and mortality. Neurology 1967;17:427–42