A Critical Review of the Evidence on the Effectiveness of Combined Perturbation-based Balance and Dual-task Gait Training for Enhancing Dynamic Stability in Parkinson's Patients

Abstract

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by gait impairment, postural instability, reduced dynamic balance, and an increased risk of falls, leading to decreased functional independence and quality of life. This literature review aimed to evaluate the effectiveness of combined perturbation-based balance training (PBT) and dual-task training (DTT) on dynamic stability in individuals with Parkinson's disease. A comprehensive search of PubMed, Google Scholar, ScienceDirect, Cochrane Library, and MDPI databases was conducted to identify studies published between 2020 and 2025. Randomized controlled trials and systematic reviews meeting the predefined inclusion criteria were reviewed. The available evidence suggests that combining PBT with DTT improves reactive postural control, gait speed, stride length, cadence, dynamic balance, functional mobility, and cognitive-motor performance while reducing fall risk. These interventions enhance sensorimotor integration and motor automaticity, resulting in better dynamic stability during functional activities. Overall, the findings indicate that combined PBT and DTT is a promising rehabilitation strategy for individuals with Parkinson's disease. However, further high-quality randomized controlled trials with standardized intervention protocols are required to confirm long-term clinical effectiveness and support evidence-based rehabilitation practice.