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Parkinson’s disease and virtual reality rehabilitation: cognitive reserve influences the walking and balance outcome

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Abstract

Introduction

Parkinson’s disease (PD) is a neurodegenerative pathology characterized by motor and non-motor symptoms that often lead to several impairments. Many studies show the efficacy of different rehabilitation protocols aimed to improve balance and gait functions in PD patients. However, multiple factors may influence rehabilitation outcome. Recently, it has been observed as the cognitive reserve (CR) may influence the rehabilitation outcome, helping to address the patient toward technological or conventional rehabilitation. Our study investigated how CR may affect motor rehabilitation outcomes in PD patients who undergo virtual reality (VR) rehabilitation, aimed at improving walking and balance.

Materials and methods

Thirty patients affected by idiopathic PD were enrolled. Patients underwent 12 sessions VR training, over 6 weeks (45 min). Six-Minute Walk Test (6MWT) and Berg Balance Scale (BBS) were used to assess walking and balance, respectively. CR was assessed by Cognitive Reserve Index questionnaire (CRIq).

Results

Significant correlations between CR and change from baseline in walking and balance measures were found, with a significant positive correlation between CRIq and 6MWT (r=0.50, p=0.01) and between CRIq and BBS (r=0.41, p=0.04).

Discussion

Our results showed that PD patients with higher CR treated with VR improved significantly more in their balance and walking distance than those with lower CR. The current study suggests that VR when aimed to improve balance and walking in PD patients is more effective in patients with higher CR.

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Acknowledgements

We would like to thank Dr. Lisa Hobson-Webb for language editing, and Barbara Di Bianco and Cristina Gargano for their technical support.

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Authors and Affiliations

  1. IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy

    Isabella Imbimbo

  2. Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy

    Isabella Imbimbo, Daniele Coraci, Giulia Piccinini & Anna Rita Bentivoglio

  3. Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy

    Daniele Coraci, Claudia Santilli, Claudia Loreti, Diego Ricciardi, Letizia Castelli, Augusto Fusco, Anna Rita Bentivoglio & Luca Padua

  4. Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy

    Luca Padua

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  1. Isabella Imbimbo
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Corresponding author

Correspondence to Daniele Coraci.

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Ethical approval statement

The study was approved by the local ethical committee.

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The authors declare no competing interests.

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Informed consent was obtained from all individual participants included in the study.

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During data collection, Claudia Santilli, Augusto Fusco, and Luca Padua were affiliated to IRCCS Fondazione Don Carlo Gnocchi IRCCS, Milan, Italy.

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Imbimbo, I., Coraci, D., Santilli, C. et al. Parkinson’s disease and virtual reality rehabilitation: cognitive reserve influences the walking and balance outcome. Neurol Sci 42, 4615–4621 (2021). https://doi.org/10.1007/s10072-021-05123-3

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