Gait adaptability training improves obstacle avoidance and dynamic stability in patients with cerebellar degeneration

Fonteyn, Ella M. R.; Heeren, Anita; Engels, Jasper-Jan C.; Boer, J.J. den; Warrenburg, B.P.C. van de; Weerdesteyn, Vivian

doi:10.1016/j.gaitpost.2014.04.190

Cited by 57 publications

(45 citation statements)

References 25 publications

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“…The relationship is indirect, and not limited only to hazardous physical features of the home environment but also related to the changes of the behavior of the older person towards safety. 31 Recent evidence suggests that obstacle avoidance 32 and gait adaptability training 33 actually reduce falls risk. An older person who fell might learn from the experience to become more aware and precautious in navigating obstacles.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with home hazards: Findings from the Malaysian Elders Longitudinal Research study

Romli

Tan

Mackenzie

et al. 2017

Geriatrics Gerontology Int

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Section: Discussionmentioning

confidence: 99%

Factors associated with home hazards: Findings from the Malaysian Elders Longitudinal Research study

Romli

Tan

Mackenzie

et al. 2017

Geriatrics Gerontology Int

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“…Two short-term open trials --a 4-week course of intensive coordinative training [96] and a 5-week gait adaptability training on an instrumented treadmill [97] --assessed in patients with degenerative ataxias, showed improvements in SARA scores.…”

Section: Physical Therapymentioning

confidence: 99%

Machado Joseph disease: clinical and genetic aspects, and current treatment

Saute

Jardim

2015

Expert Opinion on Orphan Drugs

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“…1), mimicking the step adjustments required for safe community ambulation in a cluttered environment [10]. Previous research has revealed promising results of this type of training in persons with neurological impairment, in the form of improved balance, walking [11–14] and obstacle avoidance performance [11–13]. In addition, this improved obstacle avoidance was found to be associated with reduced attentional demands of adaptive walking [13].…”

Section: Introductionmentioning

confidence: 99%

The efficacy of treadmill training with and without projected visual context for improving walking ability and reducing fall incidence and fear of falling in older adults with fall-related hip fracture: a randomized controlled trial

et al. 2016

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BackgroundThe ability to adjust walking to environmental context is often reduced in older adults and, partly as result of this, falls are common in this population. A treadmill with visual context projected on its belt (e.g., obstacles and targets) allows for practicing step adjustments relative to that context, while concurrently exploiting the great amount of walking practice associated with conventional treadmill training. The present study was conducted to compare the efficacy of adaptability treadmill training, conventional treadmill training and usual physical therapy in improving walking ability and reducing fear of falling and fall incidence in older adults during rehabilitation from a fall-related hip fracture.MethodsIn this parallel-group, open randomized controlled trial, seventy older adults with a recent fall-related hip fracture (83.3 ± 6.7 years, mean ± standard deviation) were recruited from inpatient rehabilitation care and block randomized to six weeks inpatient adaptability treadmill training (n = 24), conventional treadmill training (n = 23) or usual physical therapy (n = 23). Group allocation was only blind for assessors. Measures related to walking ability were assessed as the primary outcome before and after the intervention and at 4-week and 12-month follow-up. Secondary outcomes included general health, fear of falling, fall rate and proportion of fallers.ResultsMeasures of general walking ability, general health and fear of falling improved significantly over time. Significant differences among the three intervention groups were only found for the Functional Ambulation Category and the dual-task effect on walking speed, which were in favor of respectively conventional treadmill training and adaptability treadmill training.ConclusionsOverall, adaptability treadmill training, conventional treadmill training and usual physical therapy resulted in similar effects on walking ability, fear of falling and fall incidence in older adults rehabilitating from a fall-related hip fracture. Additional post hoc subgroup analyses, with stratification for pre-fracture tolerated walking distance and executive function, revealed several intervention effects in favor of adaptability and conventional treadmill training, indicating superiority over usual physical therapy for certain subgroups. Future well-powered studies are necessary to univocally identify the characteristics of individuals who will benefit most from a particular intervention.Trial registrationThe Netherlands Trial Register (NTR3222, 3 January 2012).Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0388-x) contains supplementary material, which is available to authorized users.

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Gait adaptability training improves obstacle avoidance and dynamic stability in patients with cerebellar degeneration

Cited by 57 publications

References 25 publications

Factors associated with home hazards: Findings from the Malaysian Elders Longitudinal Research study

Factors associated with home hazards: Findings from the Malaysian Elders Longitudinal Research study

Machado Joseph disease: clinical and genetic aspects, and current treatment

The efficacy of treadmill training with and without projected visual context for improving walking ability and reducing fall incidence and fear of falling in older adults with fall-related hip fracture: a randomized controlled trial

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