Effects of an Innovative Balance Training Programme in Enhancing Postural Control and Reducing Falls in Patients With Parkinson's Disease
试验速览
- 阶段
- 不适用
- 入组人数
- 52
- 试验地点
- 1
- 主要终点
- reaction time of limits of stability test
研究概览
简要总结
Falling is a complex and most disabling feature for patients with Parkinson's disease (PD). Previous studies suggested that falls in patients with PD are related to postural instability characterized by deficits in anticipatory postural adjustment (APA) for postural orientation in walking and standing and inadequate postural response to perturbation. The present study developed an innovative balance treatment with focus of anticipatory and compensatory postural control and examined its effects on enhancing balance and gait performance and decreasing fall rate in people with PD.
详细描述
Participants: Forty-two eligible subjects with PD were randomly allocated into balance with focus of anticipatory and compensatory postural control (EXP) or control (CON) group with strength-focused training, with 26 subjects in each group.
Methods: Subjects in the EXP group were trained the speed and amplitude of anticipatory postural adjustment during stepping and walking and postural response to perturbation during walking. Subjects In the CON group were trained to improve the strength of lower limb muscles. Treatment period in both groups lasted for 12 weeks, which consisted of 4-week laboratory-based training (phase 1), 4-week home-based exercise (phase 2) and final 4-week laboratory-based training (phase 3). Outcome measures included reaction time(RT), movement velocity (MV) and endpoint excursion (EPE) of limit-of-stability test, one-leg-stance (OLS) time, gait velocity, stride length (SL), cadence, and fall rate. All tests were conducted for 6 time intervals including baseline, after each training phase, at 3-month follow-up and at 12-month follow-up.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 45 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •diagnosed as parkinson's disease
- •45 years old or above
- •stable on anti-parkinsonian medications for at least 6 weeks prior to entry into the study, which will remain unchanged for the duration of the study
- •able to walk a 10 meter distance at least 3 times with or without walking aids independently
- •at stage 2 or 3 of the Hoehn and Yahr staging
- •able to provide informed consent
排除标准
- •neurological conditions other than PD
- •uncompensated cardiovascular disease
- •less than 23 score on the Mini-Mental State examination,
- •History of fracture or recent musculoskeletal disorders in back or lower limbs which would interfere with the balance during exercise and daily activities
- •visual disturbance or vestibular dysfunction limiting locomotion or balance
- •participation in other balance-related training program more than one time per week
研究组 & 干预措施
anticipatory and compensatory postural control training
Subjects in the experimental group were trained the speed and amplitude of anticipatory postural adjustment during fall-prone activities and postural response to perturbation during walking. Training was provided with preparatory cues, computerized machines and treadmill.
干预措施: experimental (Other)
strength-focused training
Subjects in control group were provided with strength training of leg muscles using machines and during functional activities.
干预措施: control (Other)
结局指标
主要结局
reaction time of limits of stability test
时间窗: One year
one-leg-stance time
时间窗: one year
pull test
时间窗: one year
it reflects the ability of compensatory postural control in patients with Parkinson's disease
fall rate
时间窗: previous one year before baseline assessment, each following one month for 3-month of training and 12-month of follow-up
movement velocity of limit of stability test
时间窗: one year
end point excursion of limits of stability test
时间窗: One year
次要结局
- Unified Parkinson's Disease rating scale- motor examination subscale(one year)
- Gait velocity(one year)
- Stride length(One year)
- Cadence(One year)
研究者
Margaret Kit Yi Mak
Associate Professor
The Hong Kong Polytechnic University