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Changes of biomechanics induced by Equistasi® in Parkinson’s disease: coupling between balance and lower limb joints kinematics

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Abstract

Axial disorders, including postural deformities, postural instability, and gait disturbances, are among the most disabling symptoms of Parkinson’s disease (PD). Equistasi®, a wearable proprioceptive stabilizer device, has been proposed as neurological rehabilitative device for this set of symptoms. To investigate the effects of the device on gait and balance, 24 participants affected by PD were enrolled in this crossover double-dummy, randomized, controlled study. Subjects were assessed four times before and after 8 weeks treatment with either active or placebo device; one-month wash-out was taken between treatments, in a 20-week timeframe. Gait analysis and instrumented Romberg test were performed with the aid of a sterofotogrammetric system and two force plates. Joint kinematics, spatiotemporal parameters of gait and center of pressure parameters were extracted. Paired T-test (p < 0.05) was adopted after evidence of normality to compare the variables across different acquisition sessions; Wilcoxon was adopted for non-normal distributions. Before and after the treatment with the active device, statistically significant improvements were observed in trunk flexion extension and in the ankle dorsi-plantarflexion. Regarding balance assessment, significant improvements were reported at the frequencies corresponding to vestibular system. These findings may open new possibilities on PD’s rehabilitative interventions.

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Acknowledgements

Marco Romanato’s PhD course grant is supported by Fondazione Fresco Parkinson Institute Italia Onlus. Annamaria Guiotto’s post-doctoral fellowship is supported by MIUR (Italian Minister for Education) under the initiative “Departments of Excellence” (Law 232/2016). The authors would like to acknowledge Davide Pavan and Federica Cibin for participating in the initial stage of the study.

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Authors and Affiliations

  1. Department of Information Engineering, University of Padua, Via Gradenigo 6B, 35131, Padua, Italy

    Marco Romanato, Annamaria Guiotto, Fabiola Spolaor & Zimi Sawacha

  2. Fresco Parkinson Center, Villa Margherita, S. Stefano, Vicenza, Italy

    Leila Bakdounes, Giulia Baldassarre, Alberto Cucca & Daniele Volpe

  3. The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, Department of Neurology, NYU School of Medicine, New York, NY, USA

    Alberto Cucca

  4. Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy

    Antonella Peppe

  5. Department of Medicine, University of Padua, Padua, Italy

    Zimi Sawacha

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  1. Marco Romanato
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Correspondence to Zimi Sawacha.

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Glossary

PD

Parkinson’s Disease

ST

Spatiotemporal

HS

Healthy subjects

COP

Center of pressure

EC

Eyes close

EO

Eyes open

EMG

Electromyography

BE

Before Equistasi

AE

After Equistasi

BP

Before Placebo

AP

After Placebo

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Romanato, M., Guiotto, A., Spolaor, F. et al. Changes of biomechanics induced by Equistasi® in Parkinson’s disease: coupling between balance and lower limb joints kinematics. Med Biol Eng Comput 59, 1403–1415 (2021). https://doi.org/10.1007/s11517-021-02373-3

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