Protective Step Training in People with Parkinson's Disease and Postural Disturbances

Study Rationale:
Falls are a common and challenging symptom of Parkinson's disease. The ability to execute a quick and effective movement after a loss of balance (e.g., a "protective step") may reduce the chances of a fall. Recent research suggests that practicing these protective steps may lead to step improvements and potentially fewer falls. However, such stepping practice has not been thoroughly evaluated in people with Parkinson's and balance problems.

Hypothesis:
We hypothesize that two weeks of protective step training can improve steps and reduce falls in people with Parkinson's and balance challenges.

Study Design:
People with Parkinson's disease and balance challenges will participate in two weeks of protective step training. While wearing a safety harness, participants will practice taking a quick step to retain balance while the ground moves quickly under their feet. Participants will practice these steps more than 150 times each over the 2 weeks of training. We will assess balance and cognitive performance before and after this intervention. We will also collect brain scans before the intervention to help us understand how changes in the brain may relate to changes in protective stepping. Finally, we will track how often participants fall in their home for two months before and after the intervention.

Impact on Diagnosis/Treatment of Parkinson's Disease:
Our goal is to identify the best rehabilitation interventions to prevent falls in people with Parkinson's. This study will help us understand whether one particular intervention (i.e., protective step training) can improve steps and reduce falls in people with Parkinson's and balance challenges.

Next Steps for Development:
If protective step training is shown to be effective in our study, our next step would be to determine whether it is more effective at reducing falls than other commonly used treatments in the clinic (e.g., balance training or strength training). This would provide additional information to help us understand whether this type of treatment should be integrated into care for people with Parkinson's and balance challenges.