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Interindividual balance adaptations in response to perturbation treadmill training in persons with Parkinson disease

Background and Purpose: - Perturbation training is a promising approach to reduce fall incidence in persons with Parkinson disease (PwPD). This study aimed to evaluate interindividual differences in balance adaptations in response to perturbation treadmill training (PTT) and identify potent...

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Main Authors: Klamroth, Sarah (Author) , Gaßner, Heiko (Author) , Winkler, Jürgen (Author) , Eskofier, Björn (Author) , Klucken, Jochen (Author) , Pfeifer, Klaus (Author) , Steib, Simon (Author)
Format: Article (Journal)
Language:English
Published: October 2019
In: Journal of neurologic physical therapy
Year: 2019, Volume: 43, Issue: 4, Pages: 224-232
ISSN:1557-0584
DOI:10.1097/NPT.0000000000000291
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/NPT.0000000000000291
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/jnpt/Fulltext/2019/10000/Interindividual_Balance_Adaptations_in_Response_to.6.aspx
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Author Notes:Sarah Klamroth, MA, Heiko Gaßner, PhD, Jürgen Winkler, MD, Björn Eskofier, PhD, Jochen Klucken, MD, Klaus Pfeifer, PhD, and Simon Steib, PhD
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Summary:Background and Purpose: - Perturbation training is a promising approach to reduce fall incidence in persons with Parkinson disease (PwPD). This study aimed to evaluate interindividual differences in balance adaptations in response to perturbation treadmill training (PTT) and identify potential outcome predictors. - Methods: - PwPD (n = 43, Hoehn & Yahr stage 1-3.5) were randomly assigned to either 8 weeks of PTT or conventional treadmill training (CTT) without perturbations. At baseline and following intervention, data from 4 domains of balance function (reactive, anticipatory, dynamic postural control, and quiet stance) were collected. Using responder analysis we investigated interindividual differences (responder rates and magnitude of change) and potential predictive factors. - Results: - PTT showed a significantly higher responder rate in the Mini Balance Evaluation Systems Test (Mini-BESTest) subscore reactive postural control, compared with CTT (PTT = 44%; CTT = 10%; risk ratio = 4.22, confidence interval = 1.03-17.28). Additionally, while between-groups differences were not significant, the proportion of responders in the measures of dynamic postural control was higher for PTT compared with CTT (PTT: 22%-39%; CTT: 5%-10%). The magnitude of change in responders and nonresponders was similar in both groups. PTT responders showed significantly lower initial balance performance (4/8 measures) and cognitive function (3/8 measures), and were older and at a more advanced disease stage, based on descriptive evaluation. - Discussion and Conclusions: - Our findings suggest that PTT is beneficial to improve reactive balance in PwPD. Further, PTT appeared to be effective only for a part of PwPD, especially for those with lower balance and cognitive function, which needs further attention. - Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, https://links.lww.com/JNPT/A1).
Item Description:Gesehen am 12.07.2022
Physical Description:Online Resource
ISSN:1557-0584
DOI:10.1097/NPT.0000000000000291

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