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NEW RESEARCH

Patricia Winkler, Erica DeMarch, Heather Campbell, Marcia Smith,
Use of real-time multimodal sensory feedback home program improved backward stride and retention for people with Parkinson Disease: A pilot study, Clinical Parkinsonism & Related Disorders, Volume 6, 2022, 100132

Highlights

• Multimodal sensory feedback with home exercises increased backward stride for PwPD.
• Retention of gains occurred 6 weeks after exercise ended for participants using MMSF.
• The MMSF home program improvements were likely due to integration of proprioception.
• Outcomes were highly rated by MMSF participants on a Perceived Outcome Scale.

Abstract

Introduction

Parkinson disease (PD) impairs sensory integration, contributes to motor dysfunction, loss of gait automaticity, and increased fall risk. Employing multimodal sensory feedback (MMSF) has the potential to improve proprioceptive integration and gait safety while reducing exercise burden especially for backward gait.

Methods

This single-blinded, randomized controlled pilot study used a home program with or without real-time visual, proprioceptive, and auditory feedback with stepping exercises which progressed in speed and distance. Both groups completed a six-week intervention followed by 6 weeks without exercise to assess long-term retention. Six additional weeks of exercises were completed to assess recovery of potential losses after the washout session.

Eleven people with PD exercised with real-time MMSF and 7 exercised without MMSF. Outcome measures included backward stride length, velocity, cadence, and double support time. The Dual Timed Up and Go measured automaticity. Self-perceived improvements in gait, activities of daily living, participation, and quality of life were registered by a questionnaire.

Results

Analysis was by repeated measures ANOVA. Using MMSF significantly improved backward stride length at 12 and 18 weeks, p = .007, η2 = 0.239. Both groups improved in all outcome measures after the initial 6-week exercise program, supporting efficacy of stepping exercises. The MMSF + ex group's significant improvements after a 6-week washout supported automaticity development. Questionnaire items received higher agreement percentages from MMSF + ex participants.

Conclusion

Using real-time MMSF in a home program for pwPD provided significant and lasting improvements in backward stride, and potentially decreased fall risk and exercise burden compared to the same program without MMSF.

Balance Educational Handouts:

How you Balance Handout-Connecting the Different Systems

Reliable resources, articles, books and associations are listed as a reference promoting exercise and balance.

Falls prevention for the older adult

Check your risk for falling

Home Safety Tips

    Balance, Dizziness and Vertigo

    National and Local Organizations:

    Parkinson’s Disease

    Brain Injury

    Multiple Sclerosis

    Amputee

    Oncology

    Below are some of our favorite research articles that relate to our current assessment and treatment philosophy regarding multisensory feedback and Balance Matters. 

    Podcasts:

    NPR- Hidden Brain - When Everything Clicks: The Power Of Judgment-Free Learning 

    Research Citations:

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