Physical Therapy, Rehabilitation Exercise
Conditions
Brief summary
The purpose of this exploratory single-blinded feasibility study is to explore the effects of a lateral stepping program integrated into an existing community-based group exercise program for people with PD. The researchers hypothesize that participation in a lateral stepping program a minimum of 2 times/week for 8 weeks, in addition to RSB class participation is feasible in middle to late stage PD and will decrease fall risk factors. The researchers also hypothesize that the integration of this program into an existing community-based RSB program will be deemed feasible as shown by the number of sessions attended by each participant.
Interventions
OTHERLateral Stepping Exercise 1
1\. Standing hip abduction: Performed without and with resistance bands and/or support. The participant will raise one leg out to the side and return. If using a resistance band, one end of the band will be secured to a stable surface and the other end placed around one of the participants' ankles. The banded leg will be raised to the side. Three sets of 8-12 repetitions will be performed per side.
OTHERLateral Stepping Exercise 2
2\. Lateral stepping: Performed without and with resistance bands. The participant will perform a series of steps to the side. If using a resistance band, the band will be placed around both ankles in a 'loop' and the participant will perform the lateral stepping. Three sets of 8-12 repetitions will be performed per side per subject.
OTHERLateral Stepping Exercise 3
3\. Single leg stance: The participant will stand on one leg with support as needed. The contralateral knee will be held at 45 degrees throughout the exercise. The instructor will observe to ensure the bent leg does not contact the ground. Three repetitions of static stance per side will be performed with a goal of 30 seconds, and a maximum time of 60 seconds, per repetition.
OTHERLateral Stepping Exercise 4
4\. Staggered stance mini-squat: Participants will stand with the feet hip-width apart and one leg placed a short step forward. The participant will squat straight down keeping the trunk upright and return to an upright position.
OTHERLateral Stepping Exercise 5
5\. Lateral Reactive Postural Control: The participant will lean into the researcher's hand to shift their center of mass outside of their base of support. Hand placement will be at the glenohumeral joint and the pelvis. The researcher will withdraw support and guard the participant as the participant regains their balance. This is item 6 on the Mini-BESTest assessment that will be incorporated as an intervention. To be performed 3x per side.
Sponsors
The Touro College and University System
New York Institute of Technology
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
50 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
1. A diagnosis of idiopathic PD stages II, III, or IV of the Hoehn and Yahr scale 2. 50-85 years inclusive 3. Subjects must be enrolled in RSB at NY Tech and attend at least 1 day per week for a minimum of 4 weeks prior to the first baseline assessment 4. English speaking. 5. Stable PD medication regime.
Exclusion criteria
1. Any cardiovascular or other medical condition that would affect participation 2. Any hip and/or knee surgery or other injury that would prevent full participation in the intervention 3. Neurological conditions other than PD 4. Montreal Cognitive Assessment of ≤21 5. Pain that interferes with testing 13 6. Current participation in other strengthening, stretching or balance programs other than Rock Steady Boxing at NY Tech 7. Inability to understand and fully participate in this study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The Mini-BESTest | 10-15 minutes | Performance measure, validated in people with PD, aimed to target and identify 6 different balance control systems |
| The Functional Gait Assessment | 5-20 minutes | Validated for people with PD is a performance measure validated in people with PD that is used to assess balance in the higher-functioning older adult and examines ambulation and the ability to perform motor tasks while ambulating |
| The Multidirectional Functional Reach Test | Less than 5 minutes | Used to assess stability when displacing a person's balance in a forward, lateral, and backward direction |
| The Four-Square Step Test | less than 5 minutes | Validated for people with PD is used to measure a patient's fall risk. The test requires a stopwatch and 4 canes laid in a cross pattern. The canes crossed pattern makeup 4 quadrants; quadrant 1 (bottom left), quadrant 2 (top left), quadrant 3 (top right), and quadrant 4 (bottom right). The subject is timed while they step clockwise, and then counterclockwise throughout the quadrants. An assistive device may be used. |
| The Activities Balance Confidence Scale | 5-10 minutes | Validated for people with PD, is a self-report measure of balance confidence while performing various common activities. Scale is from 0% to 100% with 100% being the most confident in their balance in a criterion. |
| The Parkinson's Disease Questionnaire-39 | approximately 10 minutes | 39-item self-administered questionnaire designed to assess 8 different quality-of-life domains. Uses a 5-point ordinal scale with 0 being never and 5 being always. Lower scores indicate a lower quality of life. |
Countries
United States
Outcome results
None listed