Description/Abstract/Artist Statement
Background:
Falls during walking are common in older adults and individuals with Parkinson’s disease (PD) [1]. These falls are often caused by trips [2]. Injuries caused by falls can be severe, in all age groups and populations. Given the potential severity of injuries resulting from falls, it is crucial to implement interventions aimed at preventing falls. Such interventions focus on anticipatory and/or reactive mechanisms. Perturbation-based gait training (PBT) addresses both mechanisms by intentionally destabilizing participants to induce a loss of stability, triggering a motor response to regain postural stability. PBT works on the principle of specificity. While earlier studies on PBT have shown promising outcomes, additional research is warranted to assess the extent to which the observed adaptations translate to real-world situations.
Methods:
Ninety older adults (age range: 60-90 years) and individuals with PD (Hoen & Yahr score 1-3) will participate in this study. Participants will be randomized into two intervention groups: a traditional gait training intervention group and perturbation-based training group (PBT). All groups will complete a fall risk questionnaire.
There will be fifteen training sessions for six weeks. For gait training intervention group, participants will walk on a M-Gait treadmill; for PBT group, participants will walk on a treadmill and respond to the unexpected disturbances. Participants will be given time to familiarize them with the set up and find their preferred speed. The PBT group will receive perturbations that will mimic trips through unilateral treadmill belt speed changes. Compensatory responses will be evaluated by quantifying changes in the outcome measures such as center of mass path and step length. Generalization of the task will be evaluated on virtual stepping targets that move unexpectedly to increase the difficulty as needed. Participants will be wearing a harness to prevent a fall in the case of not being able to recover their balance.
Results:
We will quantify three outcome measures: step length, center of mass path, and fall risk score. We expect that the average step length will increase in both groups with perturbation-based training compared to traditional gait training. We expect an increase as longer step length is associated with a better recovery after a perturbation. Second, we expect the center of mass path to be longer as well for similar reasoning. Lastly, we expect the fall risk score to decrease. Overall, we expect to see participants make improvements in measures that make them less likely to fall.
Summary:
As a result of PBT, we expect individuals to experience less falls in complex environments. Perturbation-based training is crucial for preventing falls, especially in frail populations as it exposes individuals to controlled disturbances, enhancing their reflexes and balance control mechanisms. This specialized training not only prepares participants to react effectively to perturbations but also ensures that these skills are transferable to real-life scenarios, thereby reducing the risk of falls and associated injuries. By promoting long-term stability improvements and fostering independence, perturbation-based training contributes to a better quality of life for individuals in frail populations.
Faculty Advisor/Mentor
Ashwini Kulkarni
Faculty Advisor/Mentor Department
Rehabilitation Sciences
College Affiliation
College of Health Sciences
Presentation Type
Poster
Disciplines
Physical Therapy
Session Title
Poster Session
Location
Learning Commons Lobby @ Perry Library
Start Date
3-30-2024 8:30 AM
End Date
3-30-2024 10:00 AM
Upload File
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Included in
Perturbation-Based Gait Training
Learning Commons Lobby @ Perry Library
Background:
Falls during walking are common in older adults and individuals with Parkinson’s disease (PD) [1]. These falls are often caused by trips [2]. Injuries caused by falls can be severe, in all age groups and populations. Given the potential severity of injuries resulting from falls, it is crucial to implement interventions aimed at preventing falls. Such interventions focus on anticipatory and/or reactive mechanisms. Perturbation-based gait training (PBT) addresses both mechanisms by intentionally destabilizing participants to induce a loss of stability, triggering a motor response to regain postural stability. PBT works on the principle of specificity. While earlier studies on PBT have shown promising outcomes, additional research is warranted to assess the extent to which the observed adaptations translate to real-world situations.
Methods:
Ninety older adults (age range: 60-90 years) and individuals with PD (Hoen & Yahr score 1-3) will participate in this study. Participants will be randomized into two intervention groups: a traditional gait training intervention group and perturbation-based training group (PBT). All groups will complete a fall risk questionnaire.
There will be fifteen training sessions for six weeks. For gait training intervention group, participants will walk on a M-Gait treadmill; for PBT group, participants will walk on a treadmill and respond to the unexpected disturbances. Participants will be given time to familiarize them with the set up and find their preferred speed. The PBT group will receive perturbations that will mimic trips through unilateral treadmill belt speed changes. Compensatory responses will be evaluated by quantifying changes in the outcome measures such as center of mass path and step length. Generalization of the task will be evaluated on virtual stepping targets that move unexpectedly to increase the difficulty as needed. Participants will be wearing a harness to prevent a fall in the case of not being able to recover their balance.
Results:
We will quantify three outcome measures: step length, center of mass path, and fall risk score. We expect that the average step length will increase in both groups with perturbation-based training compared to traditional gait training. We expect an increase as longer step length is associated with a better recovery after a perturbation. Second, we expect the center of mass path to be longer as well for similar reasoning. Lastly, we expect the fall risk score to decrease. Overall, we expect to see participants make improvements in measures that make them less likely to fall.
Summary:
As a result of PBT, we expect individuals to experience less falls in complex environments. Perturbation-based training is crucial for preventing falls, especially in frail populations as it exposes individuals to controlled disturbances, enhancing their reflexes and balance control mechanisms. This specialized training not only prepares participants to react effectively to perturbations but also ensures that these skills are transferable to real-life scenarios, thereby reducing the risk of falls and associated injuries. By promoting long-term stability improvements and fostering independence, perturbation-based training contributes to a better quality of life for individuals in frail populations.