Exergaming-Based Rehabilitation for Lateral Trunk Flexion in Parkinson’s Disease: A Pilot Study

Abstract: (1) Background: Axial postural deformities represent a more common disabling motor complication in Parkinson’s disease. This study aims to investigate the clinical and neurophysiological effect of a rehabilitation treatment based on exergaming. (2) Methods: A pilot observational study was conducted on nine subjects affected by Parkinson’s disease and lateral trunk flexion, as well as on nine healthy controls with regard to some clini- cal and neurophysiological outcomes (3) Results: Statistically significant improvements were observed in all clinical assessment outcomes taken in to consideration: Berg balance scale (p = 0.0078), timed up and go tests (p = 0.03), degrees of lateral trunk inclination (p = 0.0039), and anterior/posterior trunk inclination (p = 0.0039). Regarding neurophysio- logical outcomes, the pressure pain threshold was enhanced and statistically significant in all areas assessed. Moreover, tensiomyography highlighted a statistically significant improvement in the maximal radial displacement of the ipsilateral erector spinae muscles. (4) Conclusions: The clinical and neurophysiological outcomes suggest both peripheral and central effects of exergaming. Peripherally, exergaming seems to lead to a postural trunk correction through a reduction in muscle stiffness in the ipsilateral erector spinae. Centrally, exergaming seems to lead to a central pain modulation through an upregulation of cortical connectivity associated with cognitive tasks. Taken together, these results also indicate that exergaming can be a feasible and enjoyable complement to traditional rehabilitation, potentially enhancing patients’ motivation and adherence.