Clinical Study

Instrumental or Physical-Exercise Rehabilitation of Balance Improves Both Balance and Gait in Parkinson’s Disease

Table 2

Balance exercises administered to the PD-E group, based on the Otago Exercise Program [33] and guideline program for Parkinson’s disease [38, 39].

ExerciseDescription & doseProgression

TandemPlace a foot straight in front of the other, with the heel touching the toe.
Keep your balance 30 s long, then reverse your feet.
Repeat this exercise 3 times for each foot.
Difficulty was raised according to patient’s skills. Starting with half-tandem (feet not near together), going on with tandem performed on different surfaces like foam and inclined ramp.
Difficulty was further increased by keeping the eyes closed.

One leg stanceLook straight ahead. Keep your hands on your hips. Lift on your leg without touching or resting your raised leg upon other standing leg. Stay standing on one leg 30 s long, then switch between one foot and the other.
Repeat this exercise 3 times for each foot.
Difficulty was raised according to patient’s skills by utilizing different surfaces like foam or keeping one foot lifted up a step.
Difficulty was further increased by keeping the eyes closed.

Inclined rampStand upon the inclined ramp with toes toward the top. Place feet shoulder-width apart. Maintain the position 45 s long, then turn around in order to have the top by your side. Repeat for each side and one more time with the top behind.Difficulty was raised according to patient’s skills by closing up feet. Difficulty was further increased by keeping the eyes closed.

StancePlace your feet together until almost touching, looking straight ahead. Be as stable and still as possible.
Keep the position 60 s long and repeat 3 times each exercise.
Difficulty was raised according to patient’s skills by performing exercises on foam surfaces, by closing up the feet or by keeping the eyes closed.

Compensatory stepping correctionStand in front of the physiotherapist and lean on his hands. When support is released, make a step to maintain balance.
In the same way, the physiotherapist can elicit backward stepping response and lateral stepping response.
Difficulty was increased by keeping the eyes closed.