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Publication
Towards increased gait flexibility in Parkinson's disease: Clinical implications and neurophysiological mechanisms.
Book - Dissertation
In the first stage of this study, we investigated the retention effects of a novel split-belt training (SBT) intervention in patients with Parkinson's disease (PD). The proof-of-principle is based on inducing asymmetric gait by inducing split-belt perturbations in order to address core gait deficits underlying freezing of gait (FOG). The preliminary results strongly suggest that even one session of SBT provoked a more adaptive gait pattern, not observed during tied-belt training. Furthermore, turning over-ground remained improved the next day, possibly indicating synaptic long-term potentiation. Although no effect was observed on FOG, we expect that improving asymmetry and adaptive capacity during several training sessions may also impact on this debilitating symptom. Therefore, we propose to investigate, whether SBT when applied for longer and in a more clinical fashion, leads to better gait and balance in both freezers and non-freezers. We believe that by conducting a randomized clinical trial we will start to understand the full translational potential of SBT, as it probes the implicit learning ability possibly through relatively preserved cerebellar function in PD. Additionally, we will unravel the effects of SBT on brain activation with functional near-infrared spectroscopy (fNIRS) in patients with PD and healthy aged matched controls. We expect increased cortical brain activation in the pre-frontal areas and in the motor areas of PD patients during SBT compared to tied-belt walking to be able to actively adapt gait to the changing conditions, and this more so than in healthy aged matched controls.
Publication year:2024
Accessibility:Embargoed