Balance and walking impairments are disabling symptoms of Parkinson’s disease that adversely affect the performance of daily activities, reduce independence and increase the risk of falls. Around 60 per cent of people with Parkinson’s disease fall at least once a year, with a large proportion (50−86 per cent) falling multiple times in this period. A decline in the ability to adapt stepping and walking behaviour, particularly under challenging conditions, may contribute to trips and slips; which are a frequently reported cause of falls in people with Parkinson’s disease.

To further our understanding of fall risk in people living with Parkinson’s disease, the Falls and Balance lab 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 PhD student Joana Caetano. Dr Menant said that great care was made in designing a test that could mimic everyday walking challenges, for example walking along a busy street and at the last second noticing a slippery banana peel or a broken tile, that required a short, long or wide step to successfully avoid it.

The team found that compared with their healthy peers, people with Parkinson’s disease had slower and more variable stepping reaction times in a situation involving a distracting task and were less able to adapt their stepping while walking. The participants were, therefore, more likely to miss step targets and strike the obstacle on the pathway. Professor Lord considers that such impaired stepping and gait adaptability places people with Parkinson’s disease at an increased risk of falling when negotiating unexpected hazards in everyday life.

Future work will investigate whether rehabilitation interventions aimed at improving stepping and walking adaptability can reduce fall risk in people with Parkinson’s disease.

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