Split-belt Treadmill Training to Rehabilitate Freezing of Gait and Balance in Parkinson's Disease
Parkinson Disease, Freezing of Gait, Gait, Unsteady
About this trial
This is an interventional treatment trial for Parkinson Disease
Eligibility Criteria
Inclusion Criteria:
- Idiopathic PD
- Hoehn & Yahr Stage 2-3, on levodopa
- FOG, resistant to dopaminergic therapy
- Disease duration: 5-15 years
- Stable clinical response to medications or stimulation parameters (in case of DBS) for at least 3 months
- MMSE >24/30
- Able to walk on a motor-driven treadmill
Exclusion Criteria:
- Severe imbalance that limits ambulation (Hoehn &Yahr score above 3)
- Orthopedic conditions and other systemic disease affecting locomotion
- Cardiac conditions limiting the ability to walk uninterrupted for 1 hour
- Presence of other neurological disorder
- Inability to be fluent in English
Sites / Locations
- Toronto Western HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Intervention group
Control group
The velocity of the belt will be adjusted to the over-ground speed of the subject, and will be reduced on the least affected side by 25%. While the speed of the treadmill will not change throughout the study, the duration of the training will increase each week. In the first week, the SBTM training will take place for 10 minutes. There will be a 5-minute rest period, and the split-belt conditions will continue for another 10 minutes of training (total training time= 20 minutes).
The subject will continue to walk under tied-belt conditions adjusted to the over-ground walking speed. In the first week, the treadmill training will be for 10 minutes. They will get a 5-minute break, similar to the intervention group, and continue for another 10 minutes under tied-belt conditions. The duration of each session will increase by 8 minutes every week. For example, in week 1, the treadmill training will be for a total of 20 minutes; in week 2, for 28 minutes; in week 3, for 36 minutes, and so forth, until it gets to 60 minutes by week 6. The rest period will remain at 5 minutes each session, and will always take place at the halfway mark. All 3 sessions in the week will have the same duration of training. If the subject cannot tolerate the velocity or duration of the session, the protocol will be adjusted to most recently tolerated session (and will be recorded for further interpretation and analysis).