The goal of this intervention is to explore the effectiveness of a Turning Intervention (TURN-IT) to improve quality of turning in participants with Parkinson's Disease (PD). An unique exercise program has been developed - TURN-IT - in which participants practice exercises that focus on physiological constraints that impair turning ability, such as axial rigidity, narrow base of support, bradykinesia, and inflexible set-shifting. The 60 participants with PD and a history of falls in the previous 12 months, will be randomized into a 6-week, 3x/week, one-on-one TURN-IT group or No-Intervention Control group. This pilot intervention study will determine the number of subjects needed for a future clinical trial and will determine the sensitivity to change with rehabilitation our daily-life turning quality measures (such as, mean and variability of number of steps to turn, turn amplitude, turn velocity). The investigators predict that the TURN-IT program will improve turning in daily life enough to justify a larger clinical trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
55
Based on the exercise motor learning principles, participants spend 10-15 minutes at each Exercise Station that focuses on particular constraints of turning ability. The stations will focus on important underlying aspects of turning, such as weight-shifting and increasing axial rotation during functional turning tasks. Each station will be progressed across levels to make more challenging (such as adding a dual task). Initially participants will be supported in an overhead body-weight support system (ZeroG) to allow them to practice challenging exercises without the risk of falling.
Oregon Health & Science University
Portland, Oregon, United States
Change in variability in number of steps to complete a turn
Coefficient of variation in the number of steps in a turn, averaged from daily monitoring
Time frame: 6 weeks
Change in Falls Efficacy Scale International
A 16 item self-administered questionnaire to assess fear of falling. Score range 16-64 with higher score indicating more fear of falling
Time frame: 6 weeks
Change in prospective fall rate
Number of prospective falls recorded for 12 months starting from the end of intervention
Time frame: 52 weeks
Change in patient global impression of change
Question of participant's rating of mobility. Score range from 1-7 with 1-3 indicating improvement, 4 no change, and 5-7 worsening of mobility
Time frame: 6 weeks
Change in number of steps to complete a turn
Number of steps in a turning averaged from daily monitoring
Time frame: 6 weeks
Change in turn peak velocity
Peak velocity of turns averaged from daily monitoring
Time frame: 6 weeks
Change in turn angle amplitude
Peak size of turn angles averaged from daily monitoring
Time frame: 6 weeks
Change in turn duration
Time to complete turns averaged from daily monitoring
Time frame: 6 weeks
Change in turn trunk jerk
A measure of smoothness of turning; the rate of change of acceleration during a turn averaged from daily monitoring
Time frame: 6 weeks
Change in variability of double-support time
Coefficient of variation in time of double-support phase
Time frame: 6 weeks
Change in lateral trunk range
range of motion in the trunk during walking, in the lateral direction
Time frame: 6 weeks
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