Rehabilitation interventions for improving balance in Parkinson's disease: a narrative review.

INTRODUCTION: Postural instability (PI) is one of the latest clinical manifestations of Parkinson's disease (PD). Due to the limited therapeutic effect of pharmacological therapies, a favorable consideration has now become towards rehabilitation interventions. Thus, this study aimed to synthesize literature evidence to summarize the effects of rehabilitation interventions for improving balance in PD. MATERIALS AND METHODS: We conducted a narrative review of randomized-controlled clinical trials (RCTs) comparing the effects of interventions, control interventions, and no interventions on balance-related outcomes. A comprehensive search using the MEDLINE database was conducted from January 2000 to September 2021. This review included the following causes of balance-related impairments: inability to control body weight in the base of support, impaired attention and focus on balance, postural deformities, proprioceptive deficiency, sensory-motor integration, and coordination disorders, including visual and auditory-motor coordination. RESULTS: 20 RCTs were included in the review. Various balance-related outcomes were included. The included studies focused on the effectiveness of different rehabilitation interventions, including physical therapy, virtual reality and telerehabilitation, treadmill training, hydrotherapy, action observation training, balance and cues-training interventions, and cognitive rehabilitation. CONCLUSIONS: The results suggest that most of the included rehabilitation interventions have promising therapeutic effects in improving balance in PD.