Effect of longitudinal somatosensory training on executive function and fall risk on independent-living individuals with idiopathic Parkinson's disease compared to controls: a systematic review

Makan, Vishaan

Effect of longitudinal somatosensory training on executive function and fall risk on independent-living individuals with idiopathic Parkinson's disease compared to controls: a systematic review

Thesis / Dissertation

2026

Publisher

University of Cape Town

Department

Department of Human Biology

Faculty

Faculty of Health Sciences

Abstract

Introduction: Parkinson's disease (PD) is a complex neurodegenerative disorder, which is as a result of reduced dopamine production in the brain. This disease results in a variety of motor and non-motor symptoms, such as gait deficits, postural control (PC) impairments, risk of falling, bradykinesia, tremors, rigidity and executive dysfunction. There is currently no cure for PD, and pharmacological treatments can only help with certain symptoms, however, various forms of exercise and physical activity have proven to be beneficial for many aspects affecting individuals with PD. Hence, the purpose of this systematic review is to analyse and review published data on the effect of longitudinal somatosensory training (ST) on executive function (EF) and fall risk (FR) on individuals with idiopathic PD. Methods: Studies were selected from three electronic journals and databases, PubMed, EbscoHost and SAGE Journals. Three independent reviewers selected studies based on the following inclusion criteria: 1) Randomised controlled trials, 2) diagnosed idiopathic PD, 3) Participants between 2-4 on the Hoehn & Yahr scale, 4) Males or females aged ≥50 years, 5) ≥12 sessions of ST, 6) EF and FR as an outcome and 7) Studies included were published in or after 2003. Random-effects models that account for heterogeneity and 95% confidence intervals were used to pool findings. Risk of Bias was conducted using the Risk of Bias tool, to assess for any bias. Results and discussion: Of the 907 citations reviewed from the selected databases, 7 articles met the inclusion criteria, representing a total of 14 groups, (7 control and 7 experimental) representing a sample of 281 participants with their respective groups as follows, Experimental Group (EG) (n = 135) and control group CG (n = 145), comprised of males and females. Upon analysis of data, marked improvements across results of all EG's in their respective assessments for EF following ST intervention was observed. De Natale et al. (2017) presented with improvements in their EG across all tests, including Trail-Making Test-B (TMT-B), Frontal Assessment Battery (FAB) and Stroop interference for time. No statistical tests were performed or administered, due to limited assessments from a small sample. The impact of ST on FR, showed to be highly effective, however results came out statistically insignificant, once again as a result of a small sample size. Postural control (PC) improved in EG's following their respective somatosensory interventions (p = 0,066). Gait velocity improved with higher speeds recorded across all studies, however results remained statistically insignificant (p = 0,210). Questionnaire-related FR improved, with levels of confidence in Activities-Specific Balance Confidence (ABC) scale improving by 6 points and scores in FES-I dropping in EG's, however, p = 0.394, hence results being statistically insignificant. The lack of statistically significant results was attributed to the limited sample size, which could portray unreliable statistical results and incur several other limitations during this project and from included studies. Conclusion: This systematic review, found that longitudinal ST (over 12 sessions ) had a beneficial impact on EF and FR on independent-living individuals with idiopathic PD, although results were not statistically significant. Despite a small sample size, ST is recommended as a complimentary therapeutic modality alongside first line treatments, such as pharmacological agents to manage symptoms of PD. ST can be done in several methods and techniques, such as dancing, adding an instability aspect to normal exercises, complex motor tasks, dual tasking, treadmill training and PC exercises. In a South African setting, these techniques can be effectively administered in an affordable manner, safely and recommended to do at home with family, friends or guardians by health practitioners. These exercises prescribed and performed, multiple times on a weekly basis, have all shown to positively impact EF and FR, respectively in individuals with PD. However, further research is needed to improve the understanding of the overall impact of ST on EF and FR in individuals with PD and to appropriately establish a ST programme or protocol for clinicians globally and in South Africa. Lastly, based on the trends observed during this study, multiple research opportunities remain to conclusively and statistically support a potential effect.

Keywords

Parkinson's disease

somatosensory training

Reference:

Collections

Masters

Full item page