BackgroundEvidence based virtual environments (VEs) that incorporate compensatory strategies such as cueing may change motor behavior and increase exercise intensity while also being engaging and motivating. The purpose of this study was to determine if persons with Parkinson’s disease and aged matched healthy adults responded to auditory and visual cueing embedded in a bicycling VE as a method to increase exercise intensity.MethodsWe tested two groups of participants, persons with Parkinson’s disease (PD) (n = 15) and age-matched healthy adults (n = 13) as they cycled on a stationary bicycle while interacting with a VE. Participants cycled under two conditions: auditory cueing (provided by a metronome) and visual cueing (represented as central road markers in the VE). The auditory condition had four trials in which auditory cues or the VE were presented alone or in combination. The visual condition had five trials in which the VE and visual cue rate presentation was manipulated. Data were analyzed by condition using factorial RMANOVAs with planned t-tests corrected for multiple comparisons.ResultsThere were no differences in pedaling rates between groups for both the auditory and visual cueing conditions. Persons with PD increased their pedaling rate in the auditory (F 4.78, p = 0.029) and visual cueing (F 26.48, p < 0.000) conditions. Age-matched healthy adults also increased their pedaling rate in the auditory (F = 24.72, p < 0.000) and visual cueing (F = 40.69, p < 0.000) conditions. Trial-to-trial comparisons in the visual condition in age-matched healthy adults showed a step-wise increase in pedaling rate (p = 0.003 to p < 0.000). In contrast, persons with PD increased their pedaling rate only when explicitly instructed to attend to the visual cues (p < 0.000).ConclusionsAn evidenced based cycling VE can modify pedaling rate in persons with PD and age-matched healthy adults. Persons with PD required attention directed to the visual cues in order to obtain an increase in cycling intensity. The combination of the VE and auditory cues was neither additive nor interfering. These data serve as preliminary evidence that embedding auditory and visual cues to alter cycling speed in a VE as method to increase exercise intensity that may promote fitness.
There was good agreement between these distance measures for the 6MWT. The use of a pedometer was found to be a valid measure of walking distance during the 6MWT. It was also found that the method of instruction made no differences in walking distance. Although the change was minimal on the Borg scale, the RPE was found to be significantly different between far and fast trials in healthy adults. From this study, it appears that that either mode of instruction is valid in healthy community-dwelling populations. Future studies should include populations with impairments.
A randomized, retrospective chart review of 228 patients referred to Catholic Home Care; January 1, 2009 to June 30, 2009, was conducted to determine concurrent based validity of the Missouri Alliance for Home Care Tool (MAHC-10) with the Performance Oriented Mobility Scale (Tinetti), and to determine the benefit of the “Balanced Approach” rehabilitation program. A weak but significant negative relationship between the MAHC-10 and pre- ( r = −.21, p < .01) Tinetti scores was found. Significant differences in Tinetti scores pre and post intervention was found with mean improvement of 5.2 points ( t = −19.60, df, 181, p < .001; 95% CI[−5.72, −4.67]). Results of this study indicate the effectiveness of the MAHC-10–driven interdisciplinary program in the identification and management of fallers in the home.
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