Training helps people with Parkinson’s avoid falls

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The instability that often accompanies Parkinson’s disease can lead to falls and even to a fear of walking, but German researchers report that repetitive training can help people surmount these difficulties.

As Dr. Michael Jobges told AMN Health, standard Parkinson’s drugs have “negligible influence” on postural instability.

“We developed a repetitive training of compensatory steps to enhance protective postural responses by using training strategies based on recent neurophysiological research,” he explained.

Jobges and his colleagues at the University of Leipzig studied 14 patients who underwent two weeks of repetitive postural training for 20 minutes twice daily.

First—before the training sessions—the patients were given visual feedback on a computer screen showing the actual position of their center of gravity. During and after these processes the subjects repeatedly underwent analysis of posture and gait and were shown how to adjust their steps to compensate for their unsteadiness.

The repetitive training consisted of a physiotherapist applying pushes or pulls to the patient’s back or side, to which he or she responded by taking a counterbalancing step. Insufficient steps were corrected while good efforts were given “positive feedback.” The overall goal was to hold stability “after the pushes by large compensatory steps.”

After training, there were significant changes in a variety of measures, according to the teams report in the Journal of Neurology, Neurosurgery and Psychiatry. Step length increased, walking speed improved and self-rated mobility scores increased.

Moreover, the improvements persisted after two months without further training.

Thus, concluded Dr. Jobges, “the repetitive training of compensatory steps is an effective approach in the therapy of postural instability and should be applied if postural instability is evident.”

SOURCE: Journal of Neurology, Neurosurgery and Psychiatry, December 2004.

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