A Case Study on Instrumental Treadmill Using Virtual Scenery to Improve Gait Speed, Step Length and Decrease Fear of Fall in Parkinson’s Disease

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Abstract Summary
Abstract ID :
HAC1092
Submission Type
HA Staff
Authors (including presenting author) :
Cheung WN(1), Chow PY(1), Cheung KL(1), Li SM(1), Wu H(1), Cheung YW(1), Fung YK(1), Au TK(1), Ngan KT(1)
Affiliation :
(1) Physiotherapy Department (IRS), Tseung Kwan O Hospital, Kowloon East Cluster, Hospital Authority, Hong Kong, China
Introduction :
Gait deviations and mobility deficits not only hinder functional independence but also result in fall incidents in patients with Parkinson ’s disease. Research evidence supports the use of visual cues on treadmill training to improve gait and mobility in this group of patients. The incorporation of this training provides a safe, challenging and motivating environment. This offers augmented sensory, visual and auditory feedback about performance, which enables individualized repetitive practice of motor function. Most importantly, patient could transfer the acquired function into daily life.
Objectives :
To investigate the effects and benefits of visual cues combined with treadmill training to improve mobility in Parkinson ’s disease patients.
Methodology :
A patient with Parkinson’s disease was recruited from outpatient of Tseung Kwan O Hospital Physiotherapy Department. 8 sessions of 1-hour physiotherapy training per week were offered, including balance, postural stability, strengthening and gait training. Gait training was implemented on the instrumental treadmill with force platform assessment, interface and projector which allowed real-time visual cuing and gaming. The gait speed, step length and game difficulty were individualized each session according to assessment outcomes and patient’s performance. The patient was instructed to step onto the targeted footprints projected onto the treadmill and walk over obstacles in the games. The patient was assessed by physiotherapist on the initial and 8th session.
Result & Outcome :
Gait speed was improved from 0.19m/s to 0.51m/s and step length from 0.21m to 0.23m after 8 weeks of physiotherapy training including instrumental treadmill with visual cuing. The patient reported decreased fear of falling measured by Fall Efficacy Scale and the instrumental treadmill training had improved the freezing gait, rigidity, exercise tolerance and reduced risk of fall by 80-90%. There was no adverse effect reported. Visual cues on instrumental treadmill training delivers safe and quality care for improving gait speed, step length and fear of fall in Parkinson’s disease. Given the demonstrated benefits in rehabilitation, more patients with Parkinson’s disease may be engaged in instrumental treadmill training.