Parkinson's disease is a motor disorder that is a result of cell loss in a particular region of the brain. Because the primary symptoms of Parkinson's disease include trembling, gait instability and slowed movement, therapists place a great emphasis on techniques to improve patient mobility and reduce the risks of falls. Gait and step training are two forms of exercise therapy that have been shown to reduce the risk of falls and increase mobility in Parkinson's patients.
Identification
Gait training uses treadmills to simulate walking in numerous directions. The treadmill speed is usually faster than normal walking speeds. In step training, the treadmill is suddenly turned on and off, requiring patients to react quickly. This happens when the patient is facing forward, backward or to either side. It is important that anyone undergoing this training be secured in a safety harness during the exercises to make sure no injuries occur.
Significance
A 2005 study published in "NeuroRehabilitation" assigned patients to receive gait and step training and compared them to a group that did not receive this training. The training schedule consisted of one hour of training performed three times a week for eight weeks. At the end of the study period, patients that received training had a substantial reduction in falls and an increase in stride length. Patients that did not receive training experienced no change in these measures.
The Importance of Visual Cues
Visual and auditory cues, such as parallel lines placed on a walking surface, have been shown to produce significant improvements in the temporal aspects of walking. These cues can be used to enhance gait and step training. Promising approaches include alternating high and low tones during gait training to indicate leg lifts and leg drops. According to the "Journal of the Neurological Sciences," these cues help improve gait velocity and cadence to a greater extent than gait training used on its own.
Other Therapies
Parkinson's disease is caused by a loss of dopamine producing cells. Therefore therapy usually includes oral dopamine replacement therapy. In some cases drugs such as anticholinergics, pramipexole and amantadine may also help reduce symptoms. Surgical options and electrical stimulation are also used to help patients that do not respond to other therapies. Meet with a neurologist to discuss how to best manage your disease.
References
- Science Direct: Effects of Visual and Auritory Cues on Gait in Individuals with arkinson's Disease; M. Suteerawattananon et al.; 2004
- PubMed.gov: Gait and Step Training to Reduce Falls in Parkinson's Disease"; EJ Prtoas et al;2005
- National Institute of Neurological Disorders and Stroke: Parinson's Disease Information Page
