Browsing by Author "Gregory, Tania"

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    Somatosensory training for postural control in independent-living individuals with Parkinson’s disease
    (Stellenbosch : Stellenbosch University, 2015-12) Gregory, Tania; Welman, K. E.; Stellenbosch University. Faculty of Education. Dept. of Sport Science.
    ENGLISH ABSTRACT: Introduction: Postural control (PC) impairments in Parkinson’s disease (PD) involve proprioceptive processing and integration deficits. Although deficits in proprioception have a negative effect on PC, the precise contribution to postural instability in PD remains unclear. The somatosensory system incorporates both the proprioceptive and haptic feedback systems, and by applying light touch postural sway (PS) can be improved in individuals with PD. The study therefore aimed to determine if an eight-week somatosensory training program (SSTP) would influence PC in individuals with mild to moderate PD. Study design: Time-series experimental study design. Methods: Thirty-seven participants with idiopathic PD (67 9 years; H&Y: 2 1; MDS-UPDRS III: 28 14) were divided into two groups i.e. somatosensory training group (EXP; n = 24) and placebo group (PBO; n = 13). Primary outcome measures included joint position sense (JPS), sensory integration (mCTSIB), Timed-Up-and-Go (TUG), fear of falling (FES-I) and PS. Secondary outcome measures were quality of life (PDQ-39 SI), part II, III and total score of Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) and balance confidence (ABC). Participants were tested on medication, at baseline, pre- and post-intervention over a period of 16- weeks. JPS was tested at the ankle joint with the Active Movement Extent Discrimination Apparatus (AMEDA) at 10°, 11°, 12°, 13° and 14°. For the modified Clinical Test of Sensory Integration and Balance (mCTSIB) and PS with and without haptic feedback, the Instrumented Sway tri-axial accelerometer was used to assess overall PS during eight conditions i.e. eyes open (EO), eyes closed (EC), both off and on a foam pad (+F) as well as all four conditions with haptic feedback. Results: A statistically significant treatment effect was found in the EC+F (p = 0.0002), TUG (p = 0.0001), FES-I (p = 0.02), part III (p = 0.02), as well as in total score of MDS-UPDRS (p = 0.02) for the EXP group. The EXP group improved in JPS (p = 0.02), EC+F JERK (p = 0.002) and RMS (p = 0.01) as well as PDQ-39 SI (p = 0.03) after the intervention. The EXP group showed a significant improvement in the TUG before and after the Treatment phase (p < 0.05). The EXP group also showed a significant improvement for EC+F JERK (p = 0.002) and TUG (p = 0.01), with a strong tendency for better balance confidence (p = 0.07), compared to the PBO group. Both groups presented with reduced sway amplitude when receiving haptic feedback compared to no manual contact, regardless of the surface area (p < 0.01). However, no group differences were found during the Baseline and Treatment phase (p > 0.05). Conclusion: The positive findings of this study provide evidence that this SSTP could improve PC in PD individuals. However, haptic feedback cannot be altered by a SSTP, but it can improve PS in individuals with PD, regardless of the surface area.