Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Falls during walking are common in people with Parkinson's Disease (PD). Fall risk can be attributed in part to the loss of automaticity in walking and an increased reliance on sensory cues, such as the input from the balance organ. In this project the investigators want to assess the effectiveness of rehabilitation training aiming to improve this vestibular input. The effects of a visual perturbation training in a virtual reality environment will be compared to conventional treadmill training.
Fifty participants (50-65 years) with idiopathic PD (Hoehn & Yahr scale 2-3) will be randomly assigned to the intervention group receiving four weeks of VPT in a VR environment using the Gait Real-time Analysis Interactive Lab system (GRAIL) or a control group receiving four weeks of regular treadmill training. Primary outcome measures are spatio-temporal outcome parameters of gait and dynamic stability (gait speed, stride time/length, cadence, step-to-step variability, step width variability and trunk sway), and self-reported falls, and will be recorded at all testing phases (pre-test, after baseline, after intervention and after detraining). Secondary outcome measures will include assessments of central and peripheral vestibular function (Cervical and ocular Vestibular Evoked Myogenic Potentials) for correlation with the primary outcome measures. The secondary outcomes will be recorded at pre-testing and directly after the intervention phase.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental visual perturbation treadmill training | Experimental | Participants assigned to the experimental intervention will receive 6 weeks, 2x per week of visual perturbation treadmill training using the GRAIL system. This will consist of maximum 30 minutes of walking on the treadmill while translations and rotations of the projected environment are applied. |
|
| Control treadmill training | Sham Comparator | Participants assigned to the control intervention will receive 6 weeks, 2x per week of treadmill only training. This will consist of maximum 30 minutes of walking on the treadmill without any visual perturbations. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Visual perturbation treadmill training | Other | 12 sessions of (max 30 minutes) walking at comfortable speed on an instrumented treadmill in a virtual reality environment (Gait Real-time Analysis Interactive Lab system, MOTEK) with projected visual perturbations. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in gait speed after 6 weeks training | Delta in average gait speed in m/s | Week 1 to week 6 of training intervention |
| Change from baseline in cadence after 6 weeks training | Delta in steps per minute | Week 1 to week 6 of training intervention |
| Change from baseline in stride time after 6 weeks training | Delta in average duration (+variability) of a single step in ms | Week 1 to week 6 of training intervention |
| Change from baseline in step length after 6 weeks training | Delta in average length (+variability) of a single step in cm | Week 1 to week 6 of training intervention |
| Change from baseline in step width after 6 weeks training | Delta in average width(+variability) of a single step in cm | Week 1 to week 6 of training intervention |
| Change from baseline in trunk sway after 6 weeks training | Delta in medio-lateral and anterior-posterior movement of the center of mass as determined using 3D motion capturing in cm | Week 1 to week 6 of training intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Assessments of central and peripheral vestibular function | Cervical and ocular vestibular evoked myogenic potentials | Pre-test 1 at start of the study |
| Assessments of central and peripheral vestibular function |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of fear of falling | Fear of falling recorded using the Iconographical Falls Efficacy Scale | Pre-test 2 at start of the study |
| Assessment of fear of falling | Fear of falling recorded using the Iconographical Falls Efficacy Scale |
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Patrick Santens, Prof. | UZ Gent | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UZ Gent | Ghent | East-Flanders | 9000 | Belgium |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41770816 | Derived | Baggen RJ, Van Bladel A, Prins MR, Stappers J, Spildooren J, De Letter M, Bouche K, Cambier D, Maes L, Santens P. Visual perturbation training to reduce visual dependency in Parkinson's disease: A randomized controlled trial. PLoS One. 2026 Mar 2;21(3):e0343223. doi: 10.1371/journal.pone.0343223. eCollection 2026. |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D010300 | Parkinson Disease |
| D015837 | Vestibular Diseases |
| ID | Term |
|---|---|
| D020734 | Parkinsonian Disorders |
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
Not provided
Not provided
Randomized Controlled Trial
Not provided
Not provided
Participants will not be informed if they are allocated to the experimental intervention or the control 'sham' intervention.
| Regular treadmill training | Other | 12 sessions of (max 30 minutes) walking at comfortable speed on an instrumented treadmill |
|
Cervical and ocular vestibular evoked myogenic potentials
| Post-test within 1 week after conclusion of the training intervention |
| Self-reported falls | Falls recorded in fall diary | Monthly up to six months after last training |
| Post-test within 1 week after conclusion of the training intervention |
| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |
| D007759 | Labyrinth Diseases |
| D004427 | Ear Diseases |
| D010038 | Otorhinolaryngologic Diseases |