Protective Step Training in Parkinson's Disease
Condition: Parkinson Disease
MeSH terms: Parkinson Disease
Study type: Interventional

Summary: 
      The primary purpose of this project is to determine the preliminary effectiveness of
      protective step training to improve balance and reduce falls in people with Parkinson's
      disease (PD) and postural disturbances. A secondary purpose is to understand which baseline
      patient characteristics predict responsiveness to treatment. By informing 1) the
      effectiveness of a promising rehabilitative intervention, and 2) the selection of the
      participants that will be most responsive to treatment, these data may enhance clinicians'
      ability to treat balance disturbances in people with PD. Importantly, protective step
      training, described in this proposal, can be quickly deployed in the clinic at minimal cost.
      Therefore, if shown to be effective via this and subsequent trials, this approach can be
      easily integrated into care, immediately impacting a large number of people with PD.
    

Detailed description: 
      This project contains 3 aims: Aims 1 and 2 address the primary goal of this project:
      Determining the effectiveness of protective step training. Aim 1 will test whether
      perturbation training can improve protective stepping in people with PD with postural
      dysfunction. Aim 2 will test whether improvements are retained over 2 months and generalize
      to untrained perturbation tasks (which may be important for real world situations).
      Importantly, investigators will also gather exploratory data regarding the effect of
      perturbation training on falls. Aim 3 addresses the secondary goal of this project:
      Determining for whom protective step training is most beneficial. Aim 3 will relate
      behavioral factors and neuroimaging outcomes to the magnitude of improvement in protective
      stepping. All aims will be tested in people with PD who have postural disturbances.

      To complete these aims, participants will undergo 12 visits to the laboratory over the course
      of about 5 months. These will include 6 "training visits" over the course of 2 weeks,
      surrounded by 6 "assessment" visits before and after the training. During assessment visits,
      investigators will assess the ability to step quickly in response to a loss of balance (e.g.
      a slip), as well as thinking assessments and, if eligible, investigators will complete an
      MRI. During training visits, investigators will train the ability to step quickly in response
      to a slip.

      In this study, participants will serve as their own controls. As such, there is no
      randomization to multiple groups.
    

Intervention name(s): Protective Step Training
Intervention type(s): Behavioral
Intervention description(s): Participants will undergo 6, 1 hour visits (over the course of 2 weeks) where they will be exposed to repeated slips on a treadmill.
Intervention model: Single Group Assignment
Intervention model description: Multi-baseline assessment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Balance; Falls; Posture; Cognition; Training