Repetitive step training with preparatory signals improves stability limits in patients with Parkinson's disease.
As with most chronic disease in the elderly, falling is a major risk in Parkinson's Disease. One component of falling is Limit of Stability, defined as maximum displacement of the body's centre of gravity over a fixed base of support without losing balance. This study compared a group of people with Parkinson's Disease that underwent a step training class (n = 14) with a group that underwent a lower limb strengthening class for 4 weeks (n = 14). The step training intervention included training to improve the speed and amplitude of volitional stepping and response to perturbations.
The outcome measures included the limits of stability test, postural and gait sub-scorde from the Unified Parkinson's Disease Rating Scale motor score (UPDRS-PG) and spatiotermporal gait characteristics. The step training group showed significant improvements in reaction time, movement velocity, endpoint excursion limits of stability, UPDRS-PG score, and stride length when compared to the strength training group. Both groups improved significantly in gait velocity.
The main limitations of this study were a small sample size, and also none of the subjects had experienced a fall in the 12 months prior to the study. Showing that the suggested training program could decrease future fall risk among fallers would give more clinical application of these results. > From: Shen & Mak, J Rehabil Med 44 (2012) 944-949. All rights reserved to the Foundation of Rehabilitation Information.
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