Materials and methods
tremor, BBS, rigidity, PD, bradykinesia
BLIND
Patients who were diagnosed with PD by a doctor from June 2020 to October 2021 were recruited from the Sino-French Department of Neurological Rehabilitation of Gansu Provincial Hospital. Patients should have no less than two of the four classic motor symptoms of PD, including resting tremor, rigidity, bradykinesia and asymmetric onsetFifty patients were recruited into this study and randomly divided into two groups: the control group and the intervention group. Randomization was performed by a doctor who was not involved in the study. All participants signed informed consents.The study was a single blind randomized controlled trial in which the evaluator was unaware of the treatment. Pretest and post-test designs were used to evaluate the effectiveness of the training. Participants were randomly assigned to the control group or the observation group by a physician who was not involved in the study. An opaque sealed envelope was selected from 50 sealed envelopes containing group assignment.All subjects were assessed by the Berg Balance Scale (BBS), the Time Up-and-Go Test (TUG) and the built-in assessment procedures of the Pro-Kin balance training system before the training. span style=“font-family: ‘Times New Roman’; color:#0070c0; background-color:#ffffff”>The specific evaluation methods are as follows: First, subjects were asked to complete 14 items in turn according to the BBS scale, including sitting independently, standing with eyes closed, standing on one leg, walking up and down stairs, turning around for a week and so on14. Each item is rated from 0 to 4 points according to the degree of completion. The higher the score is, the better the completion is. The scores of all items are added up to obtain the total score of the BBS test. Then, the subjects were asked to conduct TUG test15. The subjects were asked to stand up from the chair, walk 3 meters to the indicating line, then turn around and sit on the chair. The therapist recorded the time spent. The average time of three tests were the result of TUG test. Finally, the built-in evaluation program of Pro-kin Visual Feedback Balance Training System (PK254, Tec nobody, Italy) was used for testing balance function. Turn on the computer and click the “Static stability Test” option on the screen. Therapist asked the subject to stand on the test table with their eyes looking straight ahead and tell the subject to hold as still as possible for 30 seconds. Then, therapist asked the subject to close eyes and hold as still as possible for 30 seconds. The system automatically recorded the movement of the center of gravity and depicted the curve of change. The total length of the trajectory generated by the center of gravity motion was called the trajectory length, and the area enclosed by the trajectory generated by the center of gravity motion was called the area of the moving ellipse. The smaller the value of these two parameters, the better the balance function. Each patient was tested twice.After the evaluation, all subjects received rehabilitation training. All participants were given conventional balance training, including body position transfer, weight shifting, movement in all directions, standing on one leg, touching objects, turning around and throwing a ball. The training was conducted 30 minutes per session, 5 times a week, for 4 weeks.The observation group was added with visual feedback balance training in addition to conventional balance training, for 20 minutes per session, 5 times a week for 4 weeks. The Pro-kin visual feedback balance training system was used. The subjects stood on the training board. The central axis of the feet was located on the A1 and A5 lines of the balance platform. The highest points of the bilateral arches were located on the A3 and A7 lines of the balance platform respectively. The Angle between the feet was 60 degrees. The training method was as follows: four fixed locks were placed under the training board, then the subjects stood on the board and looked at the computer screen. By clicking on the “stability limit” module on the computer, the subjects controlled the slight movement of the training table with their feet to control the cursor on the screen to a specified position. Next, the therapist removed the fixed lock under the training board and adjusted the resistance value to the system-recommended 5. Then the subject placed one foot on the training board and the other foot on the ground, keeping the upper body still. The subject looked at the computer screen and controlled the large amplitude movement of the balance board through the ankle joint according to the cursor indication on the screen, making the cursor on the screen reach the specified position.