Article

OBJECTIVE: To examine the feasibility and efficacy of a home-based gait
observation intervention for improving walking in Parkinson disease (PD). DESIGN:
Participants were randomly assigned to an intervention or control condition. A baseline walking assessment, a training period at home, and a posttraining
assessment were conducted. SETTING: The laboratory and participants' home and
community environments. PARTICIPANTS: Nondemented individuals with PD (N=23)
experiencing walking difficulty. INTERVENTION: In the gait observation
(intervention) condition, participants viewed videos of healthy and parkinsonian
gait. In the landscape observation (control) condition, participants viewed
videos of moving water. These tasks were completed daily for 8 days. MAIN OUTCOME
MEASURES: Spatiotemporal walking variables were assessed using accelerometers in
the laboratory (baseline and posttraining assessments) and continuously at home
during the training period. Variables included daily activity, walking speed,
stride length, stride frequency, leg swing time, and gait asymmetry.
Questionnaires including the 39-item Parkinson Disease Questionnaire (PDQ-39)
were administered to determine self-reported change in walking, as well as
feasibility. RESULTS: At posttraining assessment, only the gait observation group
reported significantly improved mobility (PDQ-39). No improvements were seen in
accelerometer-derived walking data. Participants found the at-home training tasks
and accelerometer feasible to use. CONCLUSIONS: Participants found procedures
feasible and reported improved mobility, suggesting that observational training
holds promise in the rehabilitation of walking in PD. Observational training
alone, however, may not be sufficient to enhance walking in PD. A more
challenging and adaptive task, and the use of explicit perceptual learning and
practice of actions, may be required to effect change.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS