Parkinson's Disease Clinical Trial
Falling is a complex and most disabling feature for patients with Parkinson's disease (PD). Previous studies suggested that falls in patients with PD are related to postural instability characterized by deficits in anticipatory postural adjustment (APA) for postural orientation in walking and standing and inadequate postural response to perturbation. The present study developed an innovative balance treatment with focus of anticipatory and compensatory postural control and examined its effects on enhancing balance and gait performance and decreasing fall rate in people with PD.
Participants: Forty-two eligible subjects with PD were randomly allocated into balance with
focus of anticipatory and compensatory postural control (EXP) or control (CON) group with
strength-focused training, with 26 subjects in each group.
Methods: Subjects in the EXP group were trained the speed and amplitude of anticipatory
postural adjustment during stepping and walking and postural response to perturbation during
walking. Subjects In the CON group were trained to improve the strength of lower limb
muscles. Treatment period in both groups lasted for 12 weeks, which consisted of 4-week
laboratory-based training (phase 1), 4-week home-based exercise (phase 2) and final 4-week
laboratory-based training (phase 3). Outcome measures included reaction time(RT), movement
velocity (MV) and endpoint excursion (EPE) of limit-of-stability test, one-leg-stance (OLS)
time, gait velocity, stride length (SL), cadence, and fall rate. All tests were conducted for
6 time intervals including baseline, after each training phase, at 3-month follow-up and at
12-month follow-up.
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