Freezing of Gait (FOG) is a disabling symptom common in advanced Parkinson's Disease. FOG is an independent contributor to fall risk and is only partially relieved by medication. Parkinson's patients with FOG are known to have more difficulty with gait adaptation in their day to day environment. Further, asymmetry of gait has been implicated in FOG as these episodes are often elicited during asymmetric tasks such as turning. This study will examine the effect of a single session of split-belt treadmill walking on gait adaptation, gait symmetry and FOG as well as 24 hour retention of these effects.
In this proposal, the investigators will investigate whether adapting gait to modulations imposed by a split-belt treadmill, improves walking ability and reduces FOG. The investigators will test the hypothesis that motor adaptation deficits underlie FOG and that these problems are modifiable with training. To address these suppositions, the investigators propose a multi-centric study conducted in two research labs with expertise in split-belt gait analysis and FOG: University of Leuven (KUL) and Christian-Albrechts-University Kiel (CAUK). As freezers have been shown to have more difficulty with consolidation of motor learning, the investigators aim in study I (pilot phase) to first understand which split-belt parameters are optimal for training gait flexibility and lead to consolidated gains in daily walking. For this study, the investigators will recruit 60 freezers and 60 healthy controls, pooled across centers, and manipulate different split-belt conditions in one learning and retention session.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
81
One session of 6 x 5 min with 1 min intervals.
Faculty of Movement and Rehabilitation Sciences (FaBeR)
Leuven, Belgium
University Hospital Schleswig-Holstein
Kiel, Germany
Adaptation to Split/Tied Belt
Measured with 3D motion analysis system during treadmill walking. Patients will walk for 1.5 minutes on the treadmill that will switch from tied-to-split state and back to tied state.
Time frame: 24 hours after training
Gait Asymmetry
Measured with 3D motion analysis system during straight line overground walking
Time frame: 24 hours after training
Freezing Ratio
Measured with APDM sensors during 360 degree turns
Time frame: 24 hours after training
Medio-lateral Anticipatory Postural Adjustments
Measured with APDM sensors at gait initiation
Time frame: 24 hours after training
Gait Speed during dual task walking
Measured with 3D motion analysis system during overground walking with an auditory Stroop task
Time frame: 24 hours after training
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