Authors (including presenting author) :
Chow PY(1), Li SM(1), Cheung YW(1), Choi WM(1), Au TK Tony(1)
Affiliation :
(1)Physiotherapy Department, Tseung Kwan O Hospital, Hong Kong
Introduction :
Gait deviations and mobility deficits often hinder functional independence and result in fall incidents in patients with Parkinson ’s disease(PD). Research evidence supports the use of augmented sensory, visual and auditory feedback to improve gait and mobility in this group of patients. The incorporation of this training not only provides a safe, challenging and motivating environment but also allows individualized repetitive practice of motor function.
Objectives :
To compare the effects of Virtual Reality Treadmill and Ordinary Treadmill training in improving mobility in Parkinson ’s patients.
Methodology :
30 PD patients were recruited from Physiotherapy Outpatient Department and randomly assigned into Virtual Reality Treadmill(VRT) and Ordinary Treadmill training(TT) group. 8 sessions of 1-hr physiotherapy training per week were offered. Physiotherapy training included balance, postural stability, strengthening and 20 minutes of gait training using either Virtual Reality Treadmill or Ordinary Treadmill. VRT training was implemented on the Noraxon instrumental treadmill with interface and projector allowing real-time visual cues and gaming. The patients were instructed to step onto the targeted footprints projected onto the treadmill. The projection will be adjusted in each session aiming at gradually increasing step length. During visual gaming, patients are instructed to walk over obstacles and perform cognitive activities at the same time. TT group received ordinary treadmill training without any sensory, visual or auditory feedback. 10-meter walk test, step length and Fall Efficacy Scale(FES) were measured at baseline and 8th session.
Result & Outcome :
Total 17 PD patients (7 VRT vs 10 TT) completed the training. Both groups improved in all outcome measurement but the VRT group improved more. In average, gait speed improved from 0.19m/s to 0.51m/s (more than 30%) and step length from 0.21m to 0.23m (about 15%) while FES was decreased by 9% after 8 weeks of VRT training. There was no adverse effect reported. Virtual Reality Treadmill training delivers safe and benefits for improving gait speed, step length and fear of fall in Parkinson’s disease. More patients with Parkinson’s disease should be engaged in this advance treadmill training. Future study with larger sample size and longer follow up period is needed.
