Enhancing Balance and Gait in Parkinson Disease: Immediate Effects of Massage and Foam Rolling with and Without Static Stretching

Abstract

Background: Parkinson disease (PD) is frequently associated with impaired balance, gait dysfunction, and an increased risk of falls in older adults. Although manual and self-myofascial release techniques have shown promise in rehabilitation settings, their comparative effects and their combined effects when used with static stretching remain unclear. Objectives: This study aimed to examine the acute effects of massage and foam rolling, administered alone or in combination with static stretching, on balance, motor function, gait performance, flexibility, and proprioception in older adults with PD. Methods: In this quasi-experimental pretest-posttest study, 30 older adults with PD were recruited through convenience sampling and randomly allocated to either a massage group (n = 15) or a foam rolling group (n = 15). Participants completed two intervention phases: 1) massage or foam rolling alone and 2) the same intervention combined with static stretching. Outcome measures included the Short Berg Balance Scale, single-leg stance test, Timed Up and Go (TUG) test, sit-and-reach test, and knee joint proprioception. Data were analyzed using a 2-way repeated-measures analysis of variance, and effect sizes were reported as partial eta squared (η2p). Results: Both massage and foam rolling produced significant improvements in balance, motor performance, gait, flexibility, and proprioception. The addition of static stretching further enhanced these outcomes, yielding additional moderate-to-large effects. Between-group comparisons indicated that massage elicited greater improvements in balance and gait-related outcomes than foam rolling. Conclusions: Massage and foam rolling are effective acute rehabilitation strategies for improving functional and motor outcomes in older adults with PD, with greater benefits observed when these interventions are combined with static stretching. Massage demonstrated greater efficacy than foam rolling in enhancing balance and gait. These findings support the incorporation of multimodal, targeted rehabilitation approaches to optimize functional mobility and reduce the risk of falls in this population and may be explained bysuperior effects of massage on neuromuscular regulation, muscle stiffness reduction, and sensorimotor integration.