Effect of Neurofeedback Training on Postural Stability and Fall Risk in Patients with Parkinson's Disease

Document Type : Original Article (s)

Authors

1 Department of Motor Behavior, School of Physical Education and Sport Science, Ferdowsi University of Mashhad, Mashhad, Iran

2 Associate Professor, Department of Motor Behavior, School of Physical Education and Sport Science, Ferdowsi University of Mashhad, Mashhad, Iran

Abstract

Background: When Parkinson's disease progresses, complications such as impaired balance, can affect patient's quality of life. Results have indicated that complementary program processes such as physiotherapy can reduce these complications while the brain and its waves are ignored. This study aimed to verify the effect of neurofeedback training on postural stability and fall risk in patients with  Parkinson's disease.Methods: This was an experimental research with pre-, post-test method and control group. 16 patients were selected through purposive sampling and were randomly divided to two experimental and control groups. The experimental group participated in 8 sessions of actual neurofeedback training as well as control group participated in 8 sessions of sham neurofeedback training. Before and after the training, the pre- and post-test of postural stability and fall risk were administered using biodex system.Findings: The mean scores of fall risk and the postural stability improved significantly after the intervention in experimental group (P < 0.001), while there were no significant changes among control group in fall risk (P = 0.450) and the postural stability (P = 0.750) scores.Conclusion: Our results showed that the neurofeedback training can be used to control the symptoms of Parkinson's disease, especially postural stability and fall risk.

Keywords


  1. Jankovic J, Kapadia AS. Functional decline in Parkinson's disease. Arch Neurol 2001; 58(10): 1611-5.
  2. Bronstein JM, Tagliati M, Alterman RL, Lozano AM, Volkmann J, Stefani A, et al. Deep brain stimulation for Parkinson's disease: an expert consensus and review of key issues. Arch Neurol 2011; 68(2): 165.
  3. Dimond PF. No new Parkinson's disease drug expected anytime soon. GEN news highlights. GEN-Genetic Engineering and Biotechnology News [Online]. [cited 2010 Aug 16]; Available from: URL: http://www.genengnews.com/insight-and-intelligenceand153/no-new-Parkinson disease-drug-expected-anytime-soon/77899336/
  4. Ghandehari K, Afshar M. Evaluations of risk and protective factors in Parkinsonian patients referring to neurology clinic of Southern Khorasan (UMS) in the years 2002-2003. J Rafsenjan Univ Med Sci 2004; 3 (4): 225-31.
  5. Tuchman M. A closer look at balance in Parkinson's disease for those with and without deep brain stimulation: the patient's perspective [Online]. [cited 2010]; Available from: www.dbs4pd.org/UserFiles/File/Balance12_05_09.pdf‎
  6. Morris ME. Movement disorders in people with Parkinson's disease: a model for physical therapy. Phys Ther 2000; 80(6): 578-97.
  7. Hammond DC. What is neurofeedback: an update. J Neurother 2011; 15(4): 305–36.
  8. Sherlin LH, Arns M, Lubar J, Heinrich H, Kerson C, Strehl U, et al. Neurofeedback and basic learning theory: implications for research and practice. Journal of Neurotherapy: Investigations in Neuromodulation, Neurofeedback and Applied Neuroscience 2011; 15(4): 292-304.
  9. Baydala L, Wikman E. The efficacy of neurofeedback in the management of children with attention deficit/hyperactivity disorder. Paediatr Child Health 2001; 6(7): 451-5.
  10. Landers DM, Han M, Salazar W, Petruzzello S. Effects of learning on electroencephalographic and electrocardiographic patterns in novice archers. Int J Sport Psychol 1994; 23(1): 124-9.
  11. Collura TA. Neurofeedback approach to improving at golf and other sport [Online]. [cited 2003]; Available from: URL: www.brainmaster.com/tfc/index_files/Publications/golfneuro.pdf
  12. Vernon D, Egner T, Cooper N, Compton T, Neilands C, Sheri A. The effect of distinct neurofeedback training protocols on working memory, mental rotation and attention performance. Journal of Neurotherapy 2004; 8(1): 100-1.
  13. Landers DM, Petruzzello SJ, Salazar W, Crews DJ, Kubitz KA, Gannon TL, et al. The influence of electrocortical biofeedback on performance in pre-elite archers. Med Sci Sports Exerc 1991; 23(1): 123-9.
  14. Levesque J, Beauregard M, Mensour B. Effect of neurofeedback training on the neural substrates of selective attention in children with attention-deficit/hyperactivity disorder: a functional magnetic resonance imaging study. Neurosci Lett 2006; 394(3): 216-21.
  15. Kouijzer MEJ, van Schie HT, de Moor JMH, Gerrits BJL, Buitelaar JK. Neurofeedback treatment in autism. Preliminary findings in behavioral, cognitive, and neurophysiological functioning. Research in Autism Spectrom Disorders 2010; 4(3): 386-99.
  16. Barnea A, Rassis A, Zaidel E. Effect of neurofeedback on hemispheric word recognition. Brain Cogn 2005; 59(3): 314-21.
  17. Cortoos A, Verstraeten E, Cluydts R. Neurophysiological aspects of primary insomnia: implications for its treatment. Sleep Med Rev 2006; 10(4): 255-66.
  18. Keykhahoseinpoor A, Rahnama N, Chitsaz A. Effects of eight weeks laughter yoga training on motor function, balance, and flexibility in subjects with Parkinson's disease. J Res Rehabil Sci 2013; 9(1): 39-47.
  19. Cachupe WJC, Shifflett B, Kahnov L, Wughalter EH. Reliability of biodex balance system measures. Measurement in Physical Education and Exercise Science 2001; 5(2): 97-108.
  20. Biodex Operation/Service Manual. New York, NY: Biodex Medical Systems, Inc; 2013.
  21. Hammond DC. Neurofeedback for the enhancement of athletic performance and physical balance .The Journal of the American Board of Sport Psychology 2007; 1(1): 1-9.
  22. Dailey D. Low frequency bipolar neurofeedback protocol guide book [ebook]. 2009. p. 124-41.
  23. Giroux ML. Parkinson's disease: managing a complex, progressive disease at all stages. Cleve Clin J Med 2007; 74(5): 313-8, 320.
  24. Rossi-Izquierdo M, Ernst A, Soto-Varela A, Santos-Perez S, Faraldo-Garcia A, Sesar-Ignacio A, et al. Vibrotactile neurofeedback balance training in patients with Parkinson's disease: reducing the number of falls. Gait Posture 2013; 37(2): 195-200.
  25. Basta D, Rossi-Izquierdo M, Soto-Varela A, Greters ME, Bittar RS, Steinhagen-Thiessen E, et al. Efficacy of a vibrotactile neurofeedback training in stance and gait conditions for the treatment of balance deficits: a double-blind, placebo-controlled multicenter study. Otol Neurotol 2011; 32(9): 1492-9.
  26. Thompson M, Thompson L. Biofeedback for movement disorders (dystonia with Parkinson's disease) theory and preliminary. Journal of Neurotherapy 2002; 6(4): 51-70.
  27. Subramanian L, Hindle JV, Johnston S, Roberts MV, Husain M, Goebel R, et al. Real-time functional magnetic resonance imaging neurofeedback for treatment of Parkinson's disease. J Neurosci 2011; 31(45): 16309-17.
  28. Erickson-Davis CR, Anderson JS, Wielinski CL, Richter SA, Parashos SA. Evaluation of neurofeedback training in the treatment of Parkinson's disease: a pilot study. Journal of Neurotherapy 2012; 16(1): 4-11.
  29. Fumuro T, Matsuhashi M, Mitsueda T, Inouchi M, Hitomi T, Nakagawa T, et al. Bereitschaftspotential augmentation by neuro-feedback training in Parkinson's disease. Clin Neurophysiol 2013; 124(7): 1398-405.