Esther M J Bekkers, Anat Mirelman, Lisa Alcock, Lynn Rochester, Freek Nieuwhof, Bastiaan R Bloem, Elisa Pelosin, Laura Avanzino, Andrea Cereatti, Ugo Della Croce, Jeffrey M Hausdorff, Alice Nieuwboer
Date: March 23, 2020
Overview
People with parkinson’s disease and freezing of gait (FOG+) are associated with more falls, postural instability, and cognitive impairment than people without freezing of gait (FOG−).
Purpose:
The goal of this study is to conduct a secondary analysis of the V-TIME study, a randomized, controlled research study showing a greater reduction in falls after virtual reality treadmill training (TT + VR) as compared with usual treadmill walking (TT) in a mixed population of fallers. During treadmill interventions, we examined whether FOG+ and FOG- gained similar gains.
Methods:
A total of 77 FOG+ and 44 FOG− were randomly assigned to TT + VR or TT. A six-month follow-up was conducted as well as pre- and post-training assessments. Mini Balance Evaluation System Test (Mini-BEST) was used to assess postural stability. Fall records were kept. The New Freezing of Gait Questionnaire (NFOG-Q) and Trail Making Test (TMT-B) were also used.
Findings:
Mini-BEST scores and the TMT-B improved in both groups after training (P = .001), irrespective of study arm and FOG subgroup. However, gains were not sustained at 6 months. In both FOG+ and FOG-, falls were reduced after TT + VR compared with TT (P = .008). In the FOG+ group, scores on the NFOG-Q didn’t change after both modes of training.
Conclusions:
While controlling for disease severity differences, treadmill walking (with or without VR) improved postural instability in both FOG+ and FOG- patients. Even in those with FOG, TT + VR reduced falls more than TT alone. Although postural instability, falls and FOG are related, they may be controlled by different mechanisms, as training did not help FOG.
GaitBetter has implemented commercially the V-TIME academic research project, that has led to many of these papers.
54 replies on “Do Patients With Parkinson’s Disease With Freezing of Gait Respond Differently Than Those Without to Treadmill Training Augmented by Virtual Reality?”
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