Beyond Conventional Therapy in Parkinson's Disease Patients: The Impact of Visual Feedback Training on Balance and Trunk Control – A Prospective Cohort Study

Background Postural instability and impaired balance are major contributors to disability and fall risk in individuals with Parkinson's disease (PD). Technology-assisted rehabilitation based on visual biofeedback may enhance the effects of conventional physiotherapy. This study aimed to evaluate the effects of a visual feedback training program combined with conventional physiotherapy on balance, mobility, and functional independence in patients with PD. Methods In this prospective cohort study, 21 patients with PD (Hoehn and Yahr stages 1–3) underwent a 4-week rehabilitation program consisting of 20 sessions (60 min/session, 5 sessions/week) combining conventional physiotherapy with visual-feedback balance and trunk-control training using the ProKin 252N platform. Outcomes were assessed at baseline (T0), post-treatment (T1), 3 months (T2), and 6 months (T3). Primary outcome was the Berg Balance Scale (BBS). Secondary outcomes included the Performance-Oriented Mobility Assessment (POMA), Timed Up and Go (TUG), and Functional Independence Measure (FIM). Results Significant improvements were observed after treatment in BBS (40.10 ± 8.99 vs. 43.45 ± 7.63; p < 0.001), POMA (19.00 ± 4.85 vs. 22.00 ± 3.37; p < 0.001), TUG (14.73 ± 6.10 vs. 12.84 ± 4.94 s; p = 0.010), and FIM (109.2 ± 10.75 vs. 110.2 ± 9.57; p = 0.002). Improvements were maintained at T2 and remained significantly better than baseline at T3 (BBS: 44.83 ± 7.53; Tinetti: 23.00 ± 3.38; TUG: 12.72 ± 4.47 s; FIM: 111.1 ± 8.81). Repeated-measures ANOVA demonstrated significant improvements over time for all outcomes ( p < 0.001). Conclusions Visual feedback training combined with conventional physiotherapy may improve balance, mobility, and functional independence in individuals with PD, with benefits maintained up to 6 months. Larger controlled studies are warranted to confirm these findings.