None listed
Conditions
Brief summary
The aim of this program is to reduce the risk of falls in people with Parkinson's disease using non-invasive technology to monitor and improve their walking balance. Falls are a major cause of hospitalisation in people with PD, with 60% of all sufferers experiencing a fall each year. There is strong evidence that fallers walk with greater side to side head movement along with shorter step length and a slower cadence than non-fallers. Improving gait stability by retraining the way these individuals walk may thus have great potential to reduce the risk of falls and consequently reduce fall-related hospitalisations. A cross sectional study involving approximately 30 people with PD with mild to severe disease severity will be conducted. The effect of real-time feedback on walking mechanics will be investigated. Participation in this research will require individuals to visit the school of Exercise Science's Biomechanics Laboratory at the Brisbane campus of the Australian Catholic University on two separate occasions separated by approximately 1 week to complete a series of walking assessments. During these assessments, walking mechanics will be evaluated using a 3-dimensional motion capture system. The protocol will involve each participant receiving real-time biofeedback.
Interventions
Gait retraining.
The participant will receive real-time visual biofeedback regarding the frontal plane lean of their trunk as they walk along a level indoor walkway wearing their own closed-in footwear. The feedback will be projected onto a screen at the end of the walkway in the form of a moving line representing the magnitude of their trunk lean in real-time along with a shaded zone representing a target magnitude of lean they should try to avoid. Their baseline trunk lean will be calculated u
Gait retraining. The participant will receive real-time visual biofeedback regarding the frontal plane lean of their trunk as they walk along a level indoor walkway wearing their own closed-in footwear. The feedback will be projected onto a screen at the end of the walkway in the form of a moving line representing the magnitude of their trunk lean in real-time along with a shaded zone representing a target magnitude of lean they should try to avoid. Their baseline trunk lean will be calculated using marker-based three-dimensional motion analysis during normal walking. They will then be instructed to use this feedback to modify their movement patterns to reduce the magnitude of trunk lean as they walk by 30% from their average baseline mediolateral excursion (as represented by the shaded zone). This intervention will be facilitated by an Exercise Scientist/Biomechanist and delivered in a single session at the Biomechanics laboratory, Australian Catholic University, Brisbane, Queensland, will last 10-20 minutes and will be completed at a self-selected walking pace. Outcome data will be collected across two sessions, with Session 1 consisting of: (i) Baseline walking trials (at least 5 trials), (ii) walking trials during the delivery of the intervention (at least the last 5 trials of the intervention), (iii) 5 minutes post intervention (at least 5 trials), and Session 2 consisting of (iv) follow-up walking trials (at least 5 trials). The exact number of trials under each condition will be recorded manually by the session facilitator.
Sponsors
Australian Catholic University
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
(a) diagnosis of PD by a neurologist according to the United Kingdom Parkinson’s Disease Society Brain Bank Clinical Diagnostic Criteria (Hughes, Daniel, Kilford & Lees, 1992); (b) presenting with PD-related symptoms ranging from stages 1-3 on the H&Y scale (Goetz et al, 2004).
Exclusion criteria
(a) significant surgery within the last three months that may influence walking; (b) recurrent pain or injury affecting walking; (c) an inability to walk without assistance (e.g. the use of handrails or a carer); (d) significant visual (Bailey-Lovie high contrast visual acuity >0.30 logMAR)(Brown & Lovie-Kitchin, 1989) or cognitive impairment (Addenbrooke’s Cognitive Examination score of < 82 out of 100) (Mioshi, Dawson, Mitchell, Arnold & Hodges, 2006); (e) has received deep brain stimulation; (f) is greater than 80 years of age.
Outcome results
None listed