Can a targeted home-based exercise programme improve turning characteristics in individuals with Parkinson's disease?

Khobkhun, Fuengfa; Srivanitchapoom, Prachaya; Richards, Jennifer C.

doi:10.1016/j.clinbiomech.2021.105469

Cited by 8 publications

(13 citation statements)

References 38 publications

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“…With cueing, turning became even more en-bloc with a decrease in separation of the head and pelvic rotations. Another small study focused on axial mobility to improve turns and showed improvements with a home-based exercise program [47]. The most recent Cochrane review of rehabilitation for PD summarizes studies showing improvements in gait speed but did not find rehabilitation studies to improve turning ability [48,49].…”

Section: Discussionmentioning

confidence: 99%

TURN-IT: a novel turning intervention program to improve quality of turning in daily life in people with Parkinson’s disease

et al. 2022

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Background People with Parkinson’s disease (PD) have a high fall rate and many falls are associated with turns. Despite this, there is minimal research on effects of rehabilitation on the quality of turns. Further, quantifying turns in the home may have broader implications since rehabilitation of turns would ideally improve turning in real world mobility. Methods Sixty people with PD and a history of falls will be randomized to receive either a novel TURNing InTervention (TURN-IT) or no intervention (control group). The TURN-IT group will be seen for 6 weeks (18 visits) for an individualized, progressive program that is based on the specific constraints of turning in PD. Wearable sensors will be used to measure 7 days of mobility, including turns, before and after intervention or control period. In addition, blinded assessments of gait, mobility and turns will occur before and after intervention for both groups and falls will be monitored for twelve months post intervention with bimonthly email questionnaires. Discussion This study has the potential to change how we rehabilitate and assess turning in people with PD and falls. There are several novel aspects to our study including a comprehensive turning-focused intervention that is tailored to the underlying constraints that impair turning in people with PD. Further, our outcome measure of turning quality during 7 days of daily life is novel and has implications for determining real-life changes after rehabilitation. The ultimate goal of this rehabilitation intervention is to improve how patients turn in daily life and to reduce falls. Trials registration This protocol is registered at clinicaltrials.gov; #NCT04897256; https://clinicaltrials.gov/ct2/show/NCT04897256?term=Horak&cond=Parkinson+Disease&draw=2&rank=4.

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Section: Discussionmentioning

confidence: 99%

TURN-IT: a novel turning intervention program to improve quality of turning in daily life in people with Parkinson’s disease

et al. 2022

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“…On top of being a significant motor parameter of gait performance, turning behavior is an important dopamine-mediated predictor of neuropsychiatric symptoms [e.g., ( 44 , 45 )]. Novel therapies focusing on turning can improve clinical outcomes in PD, such as the frequency of falls ( 46 ).…”

Section: Methodsmentioning

confidence: 99%

Dual-Task Treadmill Training for the Prevention of Falls in Parkinson's Disease: Rationale and Study Design

Mylius

Maes

Negele

et al. 2022

Front. Rehabilit. Sci.

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Various factors, such as fear of falling, postural instability, and altered executive function, contribute to the high risk of falling in Parkinson's disease (PD). Dual-task training is an established method to reduce this risk. Motor-perceptual task combinations typically require a patient to walk while simultaneously engaging in a perceptual task. Motor-executive dual-tasking (DT) combines locomotion with executive function tasks. One augmented reality treadmill training (AR-TT) study revealed promising results of a perceptual dual-task training with a markedly reduced frequency of falls especially in patients with PD. We here propose to compare the effects of two types of concurrent tasks, perceptual and executive, on high-intensity TT). Patients will be trained with TT alone, in combination with an augmented reality perceptual DT (AR-TT) or with an executive DT (Random Number Generation; RNG-TT). The results are expected to inform research on therapeutic strategies for the training of balance in PD.

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“…turning kinematics and stepping characteristics were assessed using a Bluegain wireless electrooculography system (EOG) and Inertial Measurement Units (IMU) sensors, respectively. The presentation of visual cues and a simultaneously marked time point within the EOG data acquisition software and the synchronisation of XSENS data streams were controlled using a LabVIEW programme 14,23,27 .…”

Section: Turning Difficulty Questionnaires and Clinical Assessmentsmentioning

confidence: 99%

“…Eye movement assessment. The BlueGain wireless electrooculography system (EOG) (Cambridge Research System Ltd., UK) was used to measure eye movement variables in terms of fast phase characteristics at a sampling frequency of 1000 Hz, similar to previous published methodologies 15,27 . Two disposable surface electrodes were placed on the outer canthi of the eyes and a reference electrode was placed on the centre of the forehead.…”

Section: Turning Difficulty Questionnaires and Clinical Assessmentsmentioning

confidence: 99%

“…Five sensors were attached to the centre of the forehead, middle thorax, pelvis and the centre of the left and right foot using Velcro straps (Fig. 1) 14,27 . A dual low-pass fourth-order Butterworth filter using a cut-off frequency of 6 Hz were applied to IMU data prior to calculating turning kinematics and stepping characteristics.…”

Section: Turning Difficulty Questionnaires and Clinical Assessmentsmentioning

confidence: 99%

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An investigation of the contribution of different turn speeds during standing turns in individuals with and without Parkinson’s disease

Khobkhun

Santiago

Tahara

et al. 2022

Sci Rep

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Issues around turning can impair daily tasks and trigger episodes of freezing of gait in individuals with Parkinson's disease (PD). Slow speeds associated with aging produce a more en-bloc movement strategy which have been linked with falls while turning. However, the influence of speed of turning on the complex whole-body coordination considering eye movements, turning kinematics, and stepping characteristics during turning has not been examined. The aim of this study was to investigate if individuals with PD have a different response to changes in turning speed compared to healthy older adults during 180° standing turns. 20 individuals with PD and 20 healthy age matched adults participated in this study. Data were collected during clockwise and counter-clockwise turns at three self-selected speeds in a randomised order: (a) normal; (b) faster than normal; and (c) slower than normal. Eye movement and turning kinematics were investigated using electrooculography and Inertial Measurement Units. Mixed Model Analysis of Variance (MM ANOVA) tests with post hoc pairwise comparisons were performed to assess the differences between groups and turning speed. In addition, further post hoc Repeated Measures ANOVA (RM ANOVA) tests were performed if any significant interactions were seen between groups and turning speed. Significant interaction effects were found in eye movement and turning kinematics, and the RM ANOVA showed significant main effects for turning speeds within the PD and the control groups. Turning slowly resulted in similar alterations in eye movement, turning kinematics and stepping characteristics in the PD group and the healthy controls. However, individuals with PD showed a different response to the healthy controls, with a greater delay in eye movement and onset latency of segments in turning kinematics and step variables between the different speeds. These findings help our understanding regarding the turning strategies in individuals with PD. The incorporation of guidance with regard to faster turning speeds may be useful in the management of individuals with PD. Clinical training using different turn directions and speeds may improve coordination, increase confidence and reduce the risk of falling.

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Can a targeted home-based exercise programme improve turning characteristics in individuals with Parkinson's disease?

Cited by 8 publications

References 38 publications

TURN-IT: a novel turning intervention program to improve quality of turning in daily life in people with Parkinson’s disease

TURN-IT: a novel turning intervention program to improve quality of turning in daily life in people with Parkinson’s disease

Dual-Task Treadmill Training for the Prevention of Falls in Parkinson's Disease: Rationale and Study Design

An investigation of the contribution of different turn speeds during standing turns in individuals with and without Parkinson’s disease

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