Balance rehabilitation by moving platform and exercises in patients with neuropathy or vestibular deficit.

Objective: To assess the efficacy of a balance rehabilitation
treatment by using both a powered platform on which subjects
stand and specific physical exercises (EXs).
Design: Crossover trial.
Setting: Physical and rehabilitation medicine department in
Italy.
Participants: Patients (N33) with balance disorders (14
vestibular origin, 19 peripheral neuropathy origin).
Interventions: Patients underwent powered platform then
EX treatment (n17); the other 16 received the same treatments
in reverse order. powered platform consisted of balancing
on a sinusoidally oscillating powered platform (in anteroposterior
and laterolateral directions in separate trials) with
eyes open and closed. A physical therapist administered Cawthorne-
Cooksey EXs for patients with vestibular disorders and
modified Frenkel EXs for patients with neuropathy. Treatment
lasted 1 hour a day for 10 consecutive days, except for the
weekend.
Main Outcome Measures: Body sway area, subjective
score of stability, balance and gait scores, and amplitude of
head displacement while balancing on the oscillating powered
platform were recorded before, (t0) after the first (t1), and after
the second treatment (t2), regardless of the powered platform
or EX order.
Results: On average, all participants improved balance regardless
of the order of treatments, and more so at t2 than t1.
Improvement was observed by using instrumental evaluations
and balance and gait scales. In both patient groups, powered
platform treatment proved to be as effective as EX in improving
balance. This effect was stronger in patients with vestibular
disorders, independently of order of treatment.
Conclusions: Balance rehabilitation with either EX or powered
platform is effective in patients with balance disorders of
vestibular or neuropathic origin. These findings point to the
value of either or both physical EXs and powered platform in
increasing stability and potentially decrease the risk of falling
in patients with neuropathy, for whom few results are documented
in the literature.