Effects of protective step training on proactive and reactive motor adaptations in Parkinson’s disease patients

The aim of this study was to investigate to what extent PD affects the ability to walk, respond to balance perturbations in a single training session, and produce acute short-term effects to improve compensatory reactions and control of unperturbed walking stability. Understanding the mechanism of c...

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Main Authors: Thurmon Lockhart, Chris Frames, Markey Olson, Seong H. Moon, Dan Peterson, Abraham Lieberman
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-10-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2023.1211441/full
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author Thurmon Lockhart
Chris Frames
Chris Frames
Markey Olson
Markey Olson
Seong H. Moon
Dan Peterson
Dan Peterson
Abraham Lieberman
author_facet Thurmon Lockhart
Chris Frames
Chris Frames
Markey Olson
Markey Olson
Seong H. Moon
Dan Peterson
Dan Peterson
Abraham Lieberman
author_sort Thurmon Lockhart
collection DOAJ
description The aim of this study was to investigate to what extent PD affects the ability to walk, respond to balance perturbations in a single training session, and produce acute short-term effects to improve compensatory reactions and control of unperturbed walking stability. Understanding the mechanism of compensation and neuroplasticity to unexpected step perturbation training during walking and static stance can inform treatment of PD by helping to design effective training regimens that remediate fall risk. Current rehabilitation therapies are inadequate at reducing falls in people with Parkinson’s disease (PD). While pharmacologic and surgical treatments have proved largely ineffective in treating postural instability and gait dysfunction in people with PD, studies have demonstrated that therapy specifically focusing on posture, gait, and balance may significantly improve these factors and reduce falls. The primary goal of this study was to assess the effectiveness of a novel and promising intervention therapy (protective step training – i.e., PST) to improve balance and reduce falls in people with PD. A secondary goal was to understand the effects of PST on proactive and reactive feedback responses during stance and gait tasks. Multiple-baseline, repeated measures analyses were performed on the multitude of proactive and reactive performance measures to assess the effects of PST on gait and postural stability parameters. In general, the results indicate that participants with PD were able to use experiences with perturbation training to integrate and adapt feedforward and feedback behaviors to reduce falls. The ability of the participants with PD to adapt to changes in task demands suggests that individuals with PD could benefit from the protective step training to facilitate balance control during rehabilitation.
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spelling doaj.art-0b38c27dec62451c90db8edc402988422023-10-26T05:21:03ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-10-011410.3389/fneur.2023.12114411211441Effects of protective step training on proactive and reactive motor adaptations in Parkinson’s disease patientsThurmon Lockhart0Chris Frames1Chris Frames2Markey Olson3Markey Olson4Seong H. Moon5Dan Peterson6Dan Peterson7Abraham Lieberman8Locomotion Research Laboratory, School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United StatesLocomotion Research Laboratory, School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United StatesMuhammad Ali Movement Disorders Clinic, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, United StatesLocomotion Research Laboratory, School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United StatesMuhammad Ali Movement Disorders Clinic, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, United StatesLocomotion Research Laboratory, School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United StatesGait and Balance Dysfunction Laboratory, College of Health Solutions, Arizona State University, Tempe, AZ, United StatesDepartment of Veteran’s Affairs, Phoenix, AZ, United StatesMuhammad Ali Movement Disorders Clinic, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, United StatesThe aim of this study was to investigate to what extent PD affects the ability to walk, respond to balance perturbations in a single training session, and produce acute short-term effects to improve compensatory reactions and control of unperturbed walking stability. Understanding the mechanism of compensation and neuroplasticity to unexpected step perturbation training during walking and static stance can inform treatment of PD by helping to design effective training regimens that remediate fall risk. Current rehabilitation therapies are inadequate at reducing falls in people with Parkinson’s disease (PD). While pharmacologic and surgical treatments have proved largely ineffective in treating postural instability and gait dysfunction in people with PD, studies have demonstrated that therapy specifically focusing on posture, gait, and balance may significantly improve these factors and reduce falls. The primary goal of this study was to assess the effectiveness of a novel and promising intervention therapy (protective step training – i.e., PST) to improve balance and reduce falls in people with PD. A secondary goal was to understand the effects of PST on proactive and reactive feedback responses during stance and gait tasks. Multiple-baseline, repeated measures analyses were performed on the multitude of proactive and reactive performance measures to assess the effects of PST on gait and postural stability parameters. In general, the results indicate that participants with PD were able to use experiences with perturbation training to integrate and adapt feedforward and feedback behaviors to reduce falls. The ability of the participants with PD to adapt to changes in task demands suggests that individuals with PD could benefit from the protective step training to facilitate balance control during rehabilitation.https://www.frontiersin.org/articles/10.3389/fneur.2023.1211441/fullParkinson’s diseaseaccidental fallsprotective step trainingmotor learninggait and balancemotor adaptability
spellingShingle Thurmon Lockhart
Chris Frames
Chris Frames
Markey Olson
Markey Olson
Seong H. Moon
Dan Peterson
Dan Peterson
Abraham Lieberman
Effects of protective step training on proactive and reactive motor adaptations in Parkinson’s disease patients
Frontiers in Neurology
Parkinson’s disease
accidental falls
protective step training
motor learning
gait and balance
motor adaptability
title Effects of protective step training on proactive and reactive motor adaptations in Parkinson’s disease patients
title_full Effects of protective step training on proactive and reactive motor adaptations in Parkinson’s disease patients
title_fullStr Effects of protective step training on proactive and reactive motor adaptations in Parkinson’s disease patients
title_full_unstemmed Effects of protective step training on proactive and reactive motor adaptations in Parkinson’s disease patients
title_short Effects of protective step training on proactive and reactive motor adaptations in Parkinson’s disease patients
title_sort effects of protective step training on proactive and reactive motor adaptations in parkinson s disease patients
topic Parkinson’s disease
accidental falls
protective step training
motor learning
gait and balance
motor adaptability
url https://www.frontiersin.org/articles/10.3389/fneur.2023.1211441/full
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