Physiotherapy strategies for balance and gait in Parkinson Disease- A Case Study

Study Design: A case study Objectives: The purpose of the study was to implement physiotherapy strategies on a single patient diagnosed with Parkinson Disease to improve balance and gait parameters. Background: Balance and gait parameters are commonly affected in Parkinson’s Disease. In order to maintain balance and gait adequate control is required from sensory and motor systems. Numerous studies have been done to improve the static and dynamic balance along with objective and subjective gait parameters in these patients but due to variation of impairments of every Parkinson patient common protocols may not be beneficial. Hence, a tailor made protocol works efficiently on individual patient. In this case study a physiotherapy protocol has been devised which can be used in any clinical setup. Methods and Measures: A 67 year old male diagnosed with Parkinson’s Disease having difficulty in balance and gait has been managed using balance and gait training for 30-60 minutes/day for 4 weeks. The treatment started with 5-10 minutes of warm up and cool down phase. The training included LSVT Big Exercises, static and dynamic exercises along with gait training using augmented visual and auditory feedback. The scores of Functional Reach Test in forward, backward and sideways direction, Berg Balance Scale, Time Up and Go test and 10 m walk test has been compared. Results: The patient depicted improvement in all four outcome measures. The scores were 25% improvement in FRT in all directions, 16% improvement in Berg Balance Scale, Time up and go Test was improved by 4 seconds and 10 m walk test by 0.92 m/s. Conclusion: The result of this case study suggests that if simple exercise interventions are planned for Parkinson patients involving Big Exercises, Perturbations and Augmented feed back then balance and gait parameters may be improved.