Abstract
Objective
To examine the feasibility and efficacy of a home-based gait observation intervention
for improving walking in Parkinson disease (PD).
Design
Participants were randomly assigned to an intervention or control condition. A baseline
walking assessment, a training period at home, and a posttraining assessment were
conducted.
Setting
The laboratory and participants' home and community environments.
Participants
Nondemented individuals with PD (N=23) experiencing walking difficulty.
Intervention
In the gait observation (intervention) condition, participants viewed videos of healthy
and parkinsonian gait. In the landscape observation (control) condition, participants
viewed videos of moving water. These tasks were completed daily for 8 days.
Main Outcome Measures
Spatiotemporal walking variables were assessed using accelerometers in the laboratory
(baseline and posttraining assessments) and continuously at home during the training
period. Variables included daily activity, walking speed, stride length, stride frequency,
leg swing time, and gait asymmetry. Questionnaires including the 39-item Parkinson
Disease Questionnaire (PDQ-39) were administered to determine self-reported change
in walking, as well as feasibility.
Results
At posttraining assessment, only the gait observation group reported significantly
improved mobility (PDQ-39). No improvements were seen in accelerometer-derived walking
data. Participants found the at-home training tasks and accelerometer feasible to
use.
Conclusions
Participants found procedures feasible and reported improved mobility, suggesting
that observational training holds promise in the rehabilitation of walking in PD.
Observational training alone, however, may not be sufficient to enhance walking in
PD. A more challenging and adaptive task, and the use of explicit perceptual learning
and practice of actions, may be required to effect change.
Keywords
List of abbreviations:
PD (Parkinson disease), PDQ-39 (39-item Parkinson Disease Questionnaire)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Locomotor function in the early stage of Parkinson’s disease.IEEE Trans Neural Syst Rehabil Eng. 2007; 15: 543-551
- Dual tasking, gait rhythmicity, and Parkinson’s disease: which aspects of gait are attention demanding?.Eur J Neurosci. 2005; 22: 1248-1256
- Gait asymmetry in patients with Parkinson’s disease and elderly fallers: when does the bilateral coordination of gait require attention?.Exp Brain Res. 2007; 177: 336-346
- Physiotherapy versus placebo or no intervention in Parkinson’s disease.Cochrane Database Syst Rev. 2013; 9: CD002817
- Tai chi and postural stability in patients with Parkinson’s disease.N Engl J Med. 2012; 366: 511-519
- Randomized controlled trial of community-based dancing to modify disease progression in Parkinson disease.Neurorehabil Neural Repair. 2012; 26: 132-143
- Cueing training in the home improves gait-related mobility in Parkinson’s disease: the RESCUE trial.J Neurol Neurosurg Psychiatry. 2007; 78: 134-140
- Evidence for motor learning in Parkinson’s disease: acquisition, automaticity and retention of cued gait performance after training with external rhythmical cues.Brain Res. 2010; 1319: 103-111
- Neural mechanisms involved in mental imagery and observation of gait.Neuroimage. 2008; 41: 1021-1031
- Levodopa reinstates connectivity from prefrontal to premotor cortex during externally paced movement in Parkinson’s disease.Neuroimage. 2014; 90: 15-23
- Patterns of cortical thickness and surface area in early Parkinson’s disease.Neuroimage. 2011; 55: 462-467
- Dopamine influences primary motor cortex plasticity and dorsal premotor-to-motor connectivity in Parkinson’s disease.Cereb Cortex. 2010; 20: 2224-2233
- Cortical thinning is associated with disease stages and dementia in Parkinson’s disease.J Neurol Neurosurg Psychiatry. 2013; 84: 875-881
- Impaired perception of biological motion in Parkinson's disease.Neuropsychology. 2016 Mar 7; ([Epub ahead of print])
- Perceptual errors increase with movement duration and may contribute to hypokinesia in Parkinson’s disease.Neuroscience. 2013; 243: 1-12
- Reduction of bradykinesia of finger movements by a single session of action observation in Parkinson disease.Neurorehabil Neural Repair. 2013; 27: 552-560
- Action observation treatment improves autonomy in daily activities in Parkinson’s disease patients: results from a pilot study.Mov Disord. 2011; 26: 1963-1964
- Action observation improves freezing of gait in patients with Parkinson’s disease.Neurorehabil Neural Repair. 2010; 24: 746-752
- fMRI responses to video and point-light displays of moving humans and manipulable objects.J Cogn Neurosci. 2001; 15: 991-1001
- Parallel visual motion processing streams for manipulable objects and human movements.Neuron. 2002; 34: 149-159
- Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases.J Neurol Neurosurg Psychiatry. 1992; 55: 181-184
- Portable activity monitoring system for temporal parameters of gait cycles.J Med Syst. 2010; 34: 959-966
- Automatic stance-swing phase detection from accelerometer data for peroneal nerve stimulation.IEEE Trans Biomed Eng. 1990; 37: 1201-1208
- Validated extraction of gait events from 3D accelerometer recordings.in: Proceedings of the IEEE International Conference on 3D Imaging; 2012 Dec 3-5; Liege (Belgium). 2012: 1-4
- Determination of heel strike and toe-off in the running stride using an accelerometer: application to field-based gait studies.in: Proceedings of the International Society of Biomechianics in Sports. 2004 Aug 8-12 (Ottawa (Canada). p 98-101)
- Monitoring walking and cycling of middle-aged to older community dwellers using wireless wearable accelerometers.Conf Proc IEEE Eng Med Biol Soc. 2012; 2012: 158-161
- The development and validation of a short measure of functioning and well-being for individuals with Parkinson’s disease.Qual Life Res. 1995; 4: 241-248
- Determining minimally important differences for the PDQ-39 Parkinson’s disease questionnaire.Age Ageing. 2001; 30: 299-302
- Motor learning and Parkinson’s disease: refinement of within-limb and between-limb coordination as a result of practice.Behav Brain Res. 2000; 111: 45-59
- Motor learning in Parkinson’s disease: limitations and potential for rehabilitation.Parkinsonism Relat Disord. 2009; 15: S53-S58
- The rationale for motor learning in Parkinson’s disease.Eur J Phys Rehabil Med. 2009; 45: 209-214
- Learning and consolidation of visuo-motor adaptation in Parkinson’s disease.Parkinsonism Relat Disord. 2009; 15: 6-11
- Implicit perceptual-motor skill learning in mild cognitive impairment and Parkinson’s disease.Neuropsychology. 2013; 27: 314-321
- Practice as an intervention to improve speeded motor performance and motor learning in Parkinson’s disease.J Neurol Sci. 2000; 174: 127-136
- Action observation activates premotor and parietal areas in a somatotopic manner: an fMRI study.Eur J Neurosci. 2001; 13: 400-404
- Action observation has a positive impact on rehabilitation of motor deficits after stroke.Neuroimage. 2007; 36: T164-T173
Article info
Publication history
Published online: January 22, 2016
Footnotes
Current affiliation for Lin, Department of Physical Therapy, Tzu Hui Institute of Technology, Nanjhou Hsian, Pingtung County 926, Taiwan.
Supported by the National Institute of Neurological Disorders and Stroke (NINDS), including a Ruth L. Kirschstein National Research Service Award (grant no. F31 NS078919) and an R01 grant (grant no. R01 NS067128). NINDS was not involved in conducting this research or preparing this article.
Disclosures: none.
Identification
Copyright
© 2016 The American Congress of Rehabilitation Medicine.
