Falls during walking are common in people with Parkinson's Disease (PD). Fall risk can be attributed in part to the loss of automaticity in walking and an increased reliance on sensory cues, such as the input from the balance organ. In this project the investigators want to assess the effectiveness of rehabilitation training aiming to improve this vestibular input. The effects of a visual perturbation training in a virtual reality environment will be compared to conventional treadmill training.
Fifty participants (50-65 years) with idiopathic PD (Hoehn \& Yahr scale 2-3) will be randomly assigned to the intervention group receiving four weeks of VPT in a VR environment using the Gait Real-time Analysis Interactive Lab system (GRAIL) or a control group receiving four weeks of regular treadmill training. Primary outcome measures are spatio-temporal outcome parameters of gait and dynamic stability (gait speed, stride time/length, cadence, step-to-step variability, step width variability and trunk sway), and self-reported falls, and will be recorded at all testing phases (pre-test, after baseline, after intervention and after detraining). Secondary outcome measures will include assessments of central and peripheral vestibular function (Cervical and ocular Vestibular Evoked Myogenic Potentials) for correlation with the primary outcome measures. The secondary outcomes will be recorded at pre-testing and directly after the intervention phase.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
35
12 sessions of (max 30 minutes) walking at comfortable speed on an instrumented treadmill in a virtual reality environment (Gait Real-time Analysis Interactive Lab system, MOTEK) with projected visual perturbations.
12 sessions of (max 30 minutes) walking at comfortable speed on an instrumented treadmill
UZ Gent
Ghent, East-Flanders, Belgium
Change from baseline in gait speed after 6 weeks training
Delta in average gait speed in m/s
Time frame: Week 1 to week 6 of training intervention
Change from baseline in cadence after 6 weeks training
Delta in steps per minute
Time frame: Week 1 to week 6 of training intervention
Change from baseline in stride time after 6 weeks training
Delta in average duration (+variability) of a single step in ms
Time frame: Week 1 to week 6 of training intervention
Change from baseline in step length after 6 weeks training
Delta in average length (+variability) of a single step in cm
Time frame: Week 1 to week 6 of training intervention
Change from baseline in step width after 6 weeks training
Delta in average width(+variability) of a single step in cm
Time frame: Week 1 to week 6 of training intervention
Change from baseline in trunk sway after 6 weeks training
Delta in medio-lateral and anterior-posterior movement of the center of mass as determined using 3D motion capturing in cm
Time frame: Week 1 to week 6 of training intervention
Assessments of central and peripheral vestibular function
Cervical and ocular vestibular evoked myogenic potentials
Time frame: Pre-test 1 at start of the study
Assessments of central and peripheral vestibular function
Cervical and ocular vestibular evoked myogenic potentials
Time frame: Post-test within 1 week after conclusion of the training intervention
Self-reported falls
Falls recorded in fall diary
Time frame: Monthly up to six months after last training
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