Effects of Rhythmic Exercise Using a Balance Ball on Parkinsonism in Binswanger Disease

Purpose: This study was performed to examine the effects of rhythmic exercise using a balance ball on parkinsonism in a patient with Binswanger disease. Subject: The study subject was a male patient in his 60s with Binswanger disease who had difficulties in sit-to-stand transition and walking due to parkinsonism with bradykinesia. Methods: This was a single-subject A-B-A-B design control study. The intervention phase A consisted of sit-to-stand training combined with rhythmic exercise using a balance ball, while the withdrawal phase B consisted of conventional sit-to-stand training. We measured the sit-to-stand time, walking speed, functional independence measure (FIM), and Unified Parkinson’s Disease Rating Scale (UPDRS) during phases A and B. Results: Sit-to-stand time showed significant improvement in the intervention phase (p < 0.05). Analysis using the split-middle line method showed a significant improving trend of sit-to-stand time during the intervention phase (p < 0.05) compared to the withdrawal phase. There were no significant changes in walking speed, FIM, or UPDRS during both phases. Conclusions: Rhythmic exercise using a balance ball improve sit-to-stand time in parkinsonism in cases of Binswanger disease. The results suggested that the effect of rhythmic cue improve response time to a start, and imbalance induced by the balance ball may facilitate stabilization of sitting position.