Advertisement

Training in varying environmental contexts facilitates transfer of improved gait performance to new contexts for individuals with Parkinson's disease - a randomized controlled trial

  • Ya-Yun Lee
    Correspondence
    Correspondence address: Ya-Yun Lee, School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Floor 3. No 17, Xuzhou Rd, Zhongzheng District, Taipei City 10055, Taiwan, R.O.C. Tel: +886-2-33668155
    Affiliations
    School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan

    Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
    Search for articles by this author
  • Chun-Hwei Tai
    Affiliations
    Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
    Search for articles by this author
  • Beth E. Fisher
    Affiliations
    Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA

    Department of Neurology, Division of Movement Disorders, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
    Search for articles by this author

      Abstract

      Objective

      To investigate whether varying practice context during gait training could reduce context-dependency and facilitate transfer of improved gait performance to a new context.

      Design

      A single-blind, parallel-group randomized controlled trial.

      Setting

      Medical university rehabilitation settings.

      Participants

      Forty-nine participants with PD were recruited and randomized into the constant (CONS) or varied (VARI) context group.

      Interventions

      All participants received 12 sessions of treadmill and over-ground gait training. The CONS group was trained in a constant environmental context throughout the study, while the VARI group received training in 2 different contexts in an alternating order.

      Main Outcome Measures

      The primary outcome was gait performance, including velocity, cadence, and stride length. The participants were assessed in the original training context as well as in a novel context at post-test to determine the influence of changed environmental context on gait performance.

      Results

      While both groups improved significantly after training, the CONS group showed greater improvement in stride length than the VARI group when assessed in the original practice context. However, the CONS group showed a decreased velocity and stride length in the novel context, while the VARI group maintained their performance.

      Conclusions

      Varying practice context could facilitate transfer of improved gait performance to a novel context.

      Keywords

      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 access
      One-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 Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect