Living well with Parkinson’s disease

More than 80,000 people are living with Parkinson’s disease (PD) in Australia, and of these, approximately two thirds will fall each year. Ensuing injuries, hospitalisations, fear of falling and caregiver burden are devastating, widespread and costly. As the prevalence of PD will double between 2010 and 2040, the associated human and economic burden will also grow. Innovative therapies to improve balance and prevent falls in PD are therefore urgently needed.

“People with PD particularly struggle with taking secure steps, avoid hazards at short notice or recovering their balance after unexpected slips or trips or if they are knocked or bumped when walking,” said Professor Stephen Lord, Senior Principal Research Fellow at NeuRA.

To further our understanding of fall risk in people living with PD, researchers at NeuRA conducted a study on the role of attention in stepping and the ability to adjust steps while walking in response to unexpected hazards. This involved a step mat test of reaction time and an obstacle course designed by former PhD student Joana Caetano.

This research showed that compared with their healthy peers, people with PD had slower and more variable reaction times in situations that involved a distracting task. They were also less able to adapt their stepping while they were walking. The participants were therefore, more likely to miss step targets and strike the obstacle in their path.

Professor Lord and his team, Dr Jasmine Menant, Dr Yoshiro Okubo and PhD student Mr Paulo Pelicioni, are now about to start a study to investigate whether a step training intervention can improve stepping and balance and reduce fall risk in people with Parkinson’s disease. As part of this four-month randomised controlled trial, participants will be allocated at-random into a control group, who will continue their daily activities as usual, or a training group. Participants in the training group will train stepping while playing games on an electronic mat connected to their television or computer, 80 to 120 min per week.

“The games are training not only stepping but also thinking abilities, are inspired from video-games such as Tetris and Pacman, are fun and their difficulty can be easily adjusted,” said Dr Jasmine Menant.

The advances in fall prevention made in this project and the team’s future work have the potential to reduce personal and financial costs to individuals, their families, healthcare resources and the community.

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