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Improvements in Average Stability Score, and a Decrease in Subjective Balance Issues Following Neurological Rehabilitation for a 62-year-old Male Patient with Parkinson’s Disease

Emily R. Kalambaheti1*, Matthew M. Antonucci1, 2, Paul E. Link1, Mia Cozart3 and Michael Greenwell1
  • 1 Plasticity Brain Centers, United States
  • 2 Carrick Institute, United States
  • 3 University of Central Florida, United States

Presentation: A 62-year-old male patient presented to Plasticity Brain Centers for evaluation and treatment of previously diagnosed Parkinson’s disease identified thirteen years prior. One of his chief complaints was balance issues. Findings: Upon intake, a Comprehensive Assessment of Postural Systems (CAPS®) (Pagnacco 2014) was performed assessing balance and stability, on both a solid and foamed surface, with eyes opened, eyes closed, and with multiple head positions. The average stability score on intake was calculated as 52.961%. When rating his subjective balance issues, the patient reported a 1 out of 6 in severity (with 0 being none and 6 being severe). Methods: A 5-day, multi-modal program of neurological exercises was administered in 10 one-hour treatment sessions (Carrick 2017)(Antonucci 2016). Each session consisted of repetitive peripheral somatosensory stimuli, cognitive exercises, neuromuscular reeducation exercises, vestibular rehabilitation exercises, orthoptic exercises, and off-vertical axis rotation (Gdowski 1999) utilizing a multi-axis rotational chair (MARC). Outcome: Upon exit, the stability scores improved, with the average stability score calculated as 62.503% (+18.02%). When comparing the individual stability scores, upon intake the patient was unable to complete the eyes closed test on a foam surface, upon exit, the patient not only completed the test but scored a 63.32% (+∞). In addition, the patient’s subjective balance score decreased from 1 to 0, indicating subjectively that his balance issues have been resolved. Conclusion: The authors suggest further investigation into multi-modal, intensive approaches to improve average stability scores and decrease subjective balance issue severity in patients with Parkinson’s Disease.

Acknowledgements

The authors would like to thank and acknowledge the contribution of the clinical team at Plasticity Brain Centers, as well as the administrative support team. The authors would also like to thank the Carrick Institute for providing the education utilized to create the multi-modal treatments implemented in this case study.

References

1. Antonucci MM, Link PE, Barton DA and Carrick FR (2016). Improvement of symptoms, balance, and gait in a geriatric male, with a 5-day intensive combination of visual, vestibular, proprioceptive, and non-invasive nerve stimulation. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience: Clinical Neuroscience for Optimization of Human Function. doi: 10.3389/conf.fneur.2016.59.00050

2. Carrick FR, Clark JF, Pagnacco G, Antonucci MM, Hankir A, Zaman R and Oggero E (2017) Head–Eye Vestibular Motion Therapy Affects the Mental and Physical Health of Severe Chronic Postconcussion Patients. Front. Neurol. 8:414. doi: 10.3389/fneur.2017.00414

3. Gdowski GT, McCrea RA. Integration of vestibular and head movement signals in the vestibular nuclei during whole-body rotation. J Neurophysiol (1999) 82:436–49

4. Pagnacco G, Carrick FR, Wright CH, Oggero E. In-situ verification of accuracy, precision and resolution of force and balance platforms. Biomed Sciences instrumentation (2014) 50:171-8

5. Simon M, Maerlender A, Metzger K, Decoster L, Hollingworth A, McLeod TV. Reliability and Concurrent Validity of Select C3 Logix Test Components. Developmental Neuropsychology (2017) Oct; 0: 1-14. Doi: 10.1080/87565641.2017.1383994. Epub 2017 Oct 25.

Keywords: Parkinson Disease, balance, Movement Disorders, Neurorehabilitation, Neurology, cognitive training, Vestibular Rehabilitation, neurological rehabilitation

Conference: International Symposium on Clinical Neuroscience 2018, Orlando, Florida, United States, 24 May - 26 May, 2018.

Presentation Type: Poster

Topic: Clinical Applications in health, disease, and injury to the nervous system

Citation: Kalambaheti ER, Antonucci MM, Link PE, Cozart M and Greenwell M (2018). Improvements in Average Stability Score, and a Decrease in Subjective Balance Issues Following Neurological Rehabilitation for a 62-year-old Male Patient with Parkinson’s Disease. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience 2018. doi: 10.3389/conf.fneur.2018.60.00014

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Received: 28 Mar 2018; Published Online: 14 Dec 2018.

* Correspondence: Dr. Emily R Kalambaheti, Plasticity Brain Centers, Orlando, United States, Emily.Kalambaheti@gmail.com