Gait and postural deficits are the most common impairments in patients with Parkinson’s Disease (PD). These impairments often reduce patients’ quality of life. Equistasi® is a wearable proprioceptive stabilizer that converts body thermic energy into mechanical vibration. No systematic reviews have been published investigating the influences of Equistasi® on gait and postural control in patients with PD. This review aimed to examine the effects of proprioceptive focal stimulation (Equistasi®) on gait deficits and postural instability in patients with PD. PubMed, Scopus, PEDro, REHABDATA, web of science, CHAINAL, EMBASE, and MEDLINE were searched from inception to July 2021. The methodological quality of the selected studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Five studies met the eligibility criteria. The scores on the PEDro scale ranged from 3 to 8, with a median score of 8. The results showed evidence for the benefits of the proprioceptive focal stimulation (Equistasi®) on gait and postural stability in individuals with PD. Proprioceptive focal stimulation (Equistasi®) appears to be safe and well-tolerated in patients with PD. Proprioceptive focal stimulation (Equistasi®) may improve gait ability and postural stability in patients with PD. Further high-quality studies with long-term follow-ups are strongly needed to clarify the long-term effects of proprioceptive focal stimulation (Equistasi®) in patients with PD.
DengHWangPJankovicJ.The genetics of Parkinson disease. Ageing Res Rev2018; 42: 72–85.
2.
TramontanoMBonnìSMartino CinneraA, et al. Blindfolded balance training in patients with Parkinson’s disease: a sensory-motor strategy to improve the gait. Parkinsons Dis2016; 2016: 1–6.
3.
CanningCGAdaLJohnsonJJ, et al. Walking capacity in mild to moderate Parkinson’s disease. Arch Phys Med Rehabil2006; 87: 371–375.
4.
SohSEMorrisMEMcGinleyJL.Determinants of health-related quality of life in Parkinson’s disease: a systematic review. Parkinsonism Relat Disord2011; 17: 1–9.
5.
SmuldersKDaleMLCarlson-KuhtaP, et al. Pharmacological treatment in Parkinson’s disease: effects on gait. Parkinsonism Relat Disord2016; 31: 3–13.
6.
HassCJBishopMMoscovichM, et al. Defining the clinically meaningful difference in gait speed in persons with Parkinson disease. J Neurol Phys Ther2014; 38: 233–238.
7.
LamontRMMorrisMEWoollacottMH, et al. Community walking in people with Parkinson’s disease. Parkinsons Dis2012; 2012: 1–8.
8.
MorrisMEMartinCLSchenkmanML.Striding out with Parkinson disease: evidence-based physical therapy for gait disorders. Phys Ther2010; 90: 280–288.
9.
SandriniGHömbergVSaltuariL, et al. Advanced technologies for the rehabilitation of gait and balance disorders. Cham: Springer Publishing Company, 2018.
10.
KleinerAGalliMGaglioneM, et al. The Parkinsonian gait spatiotemporal parameters quantified by a single inertial sensor before and after automated mechanical peripheral stimulation treatment. Parkinsons Dis2015; 2015: 1–6.
11.
AshooriAEaglemanDMJankovicJ.Effects of auditory rhythm and music on gait disturbances in Parkinson’s disease. Front Neurol2015; 6: 1–11.
12.
WangBShenMWangYX, et al. Effect of virtual reality on balance and gait ability in patients with Parkinson’s disease: a systematic review and meta-analysis. Clin Rehabil2019; 33: 1130–1138.
13.
FundaròCMaestriRFerrieroG, et al. Self-selected speed gait training in Parkinson’s disease: robot-assisted gait training with virtual reality versus gait training on the ground. Eur J Phys Rehabil Med2019; 55: 456–462.
AriasPChouzaMVivasJ, et al. Effect of whole body vibration in Parkinson’s disease: a controlled study. Mov Disord2009; 24: 891–898.
16.
GiardiniMNardoneAGodiM, et al. Instrumental or physical-exercise rehabilitation of balance improves both balance and gait in Parkinson’s disease. Neural Plast2018; 2018: 1–17.
17.
VolpeDPavanDGuiottoA, et al. Effect of underwater gait training on Parkinson’s disease: assessment through 3D underwater and on land gait analysis. Gait Posture2016; 49: S25–S26.
18.
FerrazzoliDOrtelliPCuccaA, et al. Motor-cognitive approach and aerobic training: a synergism for rehabilitative intervention in Parkinson’s disease. Neurodegener Dis Manag2020; 10: 41–55.
19.
VolpeDGiantinMGFasanoA.A wearable proprioceptive stabilizer (Equistasi®) for rehabilitation of postural instability in Parkinson’s disease: a phase II randomized double-blind, double-dummy, controlled study. PLoS One2014; 9: e112065.
20.
AlfonsiEPaonePTassorelliC, et al. Acute effects of high-frequency microfocal cortical excitability changes over time in progressive multiple sclerosis muscle. A double-blind study in healthy subjects. Funct Neurol2015; 30: 269–274.
21.
PeppeAParavatiSBaldassarreMG, et al. Proprioceptive focal stimulation (Equistasi®) may improve the quality of gait in middle-moderate Parkinson’s disease patients. Double-blind, double-dummy, randomized, crossover, Italian multicentric study. Front Neurol2019; 10: 998.
22.
SpinaECarotenutoAAcetoMG, et al. The effects of mechanical focal vibration on walking impairment in multiple sclerosis patients: a randomized, double-blinded vs placebo study. Restor Neurol Neurosci2016; 34: 869–876.
23.
SchirinziTRomanoAFavettaM, et al. Non-invasive focal mechanical vibrations delivered by wearable devices: an open-label Pilot Study in childhood ataxia. Front Neurol2018; 9: 849.
24.
RomanatoMGuiottoASpolaorF, et al. Changes of biomechanics induced by Equistasi® in Parkinson’s disease: coupling between balance and lower limb joints kinematics. Med Biol Eng Comput2021; 59: 1403–1415.
25.
UrrútiaGBonfillX.Declaración PRISMA: una propuesta para mejorar la publicación de revisiones sistemáticas y metaanálisis. Medicina Clínica2010; 135: 507–511.
26.
LiberatiAAltmanDGTetzlaffJ, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med2009; 151: W65–W94.
27.
MaherCGSherringtonCHerbertRD, et al. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther2003; 83: 713–721.
28.
MoherDShamseerLClarkeM, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev2015; 4(1): 1.
29.
FoleyNCBhogalSKTeasellRW, et al. Estimates of quality and reliability with the physiotherapy evidence-based database scale to assess the methodology of randomized controlled trials of pharmacological and nonpharmacological interventions. Phys Ther2006; 86: 817–824.
SpolaorFRomanatoMAnnamariaG, et al. Relationship between muscular activity and postural control changes after proprioceptive focal stimulation (Equistasi®) in middle-moderate Parkinson’s disease patients: an explorative study. Sensors2021; 21: 560.
32.
PeppeAPaonePParavatiS, et al. Proprioceptive focal stimulation (Equistasi®) may improve motor symptoms in moderate Parkinson’s disease patients Italian multicentric preliminary open study. In: The fourth international conference on smart portable, wearable, implantable and disability-oriented devices and systems. Barcelona, Spain: International Academy, Research, and Industry Association, 2018, pp.21–24.
33.
Welcome to the Equistasi® Network - Equistasi. English, http://www.equistasi.com/en/ (2021, accessed August 12, 2021).
34.
HanJKimEJungJ, et al. Effect of muscle vibration on spatiotemporal gait parameters in patients with Parkinson’s disease. J Phys Ther Sci2014; 26: 671–673.
35.
LopezSBiniFDel PercioC, et al. Electroencephalographic sensorimotor rhythms are modulated in the acute phase following focal vibration in healthy subjects. Neuroscience2017; 352: 236–248.
36.
ValkovičPKrafczykSBötzelK.Postural reactions to soleus muscle vibration in Parkinson’s disease: scaling deteriorates as disease progresses. Neurosci Lett2006; 401: 92–96.
37.
ThompsonMMedleyA.Forward and lateral sitting functional reach in younger, middle-aged, and older adults. J Geriatr Phys Ther2007; 30: 43–48.
38.
EklundG.General features of vibration-induced effects on balance. Ups J Med Sci1972; 77: 112–124.
AlashramARPaduaEHammashAK, et al. Effectiveness of virtual reality on balance ability in individuals with incomplete spinal cord injury: a systematic review. J Clin Neurosci2020; 72: 322–327.
41.
AlashramARAnninoGMercuriNB.Rhythmic auditory stimulation in gait rehabilitation for traumatic brain and spinal cord injury. J Clin Neurosci2019; 69: 287–288.
42.
AlashramARPaduaEAnninoG.Effects of whole-body vibration on motor impairments in patients with neurological disorders: a systematic review. Am J Phys Med Rehabil2019; 98: 1084–1098.
43.
AlashramARAnninoGPaduaE.Robot-assisted gait training in individuals with spinal cord injury: a systematic review for the clinical effectiveness of Lokomat. J Clin Neurosci2021; 91: 260–269.
44.
AlashramAR.Optimizing gait ability after task-oriented circuit class training in posttraumatic brain injury: a case report. Ind J Phys Med Rehabil2019; 30: 112–116.
45.
PalazzoFNardiALamouchideliN, et al. The effect of age, sex and a firm-textured surface on postural control. Exp Brain Res2021; 239: 2181–2191.
46.
AlashramARPaduaERomagnoliC, et al. Effectiveness of focal muscle vibration on hemiplegic upper extremity spasticity in individuals with stroke: a systematic review. NeuroRehabilitation2019; 45: 471–481.
47.
AlashramARAnninoGRajuM, et al. Effects of physical therapy interventions on balance ability in people with traumatic brain injury: a systematic review. NeuroRehabilitation2020; 46: 455–466.
48.
HigginsJAltmanD.Cochrane handbook for systematic reviews of interventions version 50. Chichester: John Wiley & Sons, Ltd, 2008.
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