Date of Award

Summer 7-9-2024

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Kinesiology and Health

First Advisor

Dr. Feng Yang

Second Advisor

Dr. Chris Ingalls

Third Advisor

Dr. Jeff Otis

Fourth Advisor

Dr. Pey-Shan Wen

Abstract

Gait and stability impairments are common symptoms of Parkinson’s disease (PD) that can lead to a loss of mobility, increased fall risk, and a decreased quality of life. Rhythmic auditory cueing has commonly been used to improve gait speed by increasing cadence without modulating step length. However, most of the current rhythmic auditory cueing-based training modalities only control the speed and people with PD may just increase their step frequency without changing the stride length to walk faster. The increased cadence could be problematic for people with PD who may have already experienced high cadence and short steps, like in the shuffling gait. Given the interrelations between gait speed, step length, and cadence, investigating the effects of gait interventions that control speed and cadence simultaneously may be warranted. The primary purpose of this randomized controlled pilot study was to examine the acute effects of a treadmill walking intervention, which manipulates the step length and gait speed concurrently, on gait quality in people with PD. Thirty-two participants diagnosed with PD (age: 67.13 ± 6.23 years) were randomly assigned to a 30-minute treadmill walking intervention that controlled speed and cadence (the advanced group) or only speed (the regular group). Before, in the middle of, and after the intervention, stride length (primary outcome), speed, cadence, and other spatiotemporal gait parameters (secondary) and dynamic gait stability (tertiary outcome), were assessed during overground walking and compared between groups over sessions. The results suggest the advanced treadmill intervention increases stride length (p = 0.04), gait speed (p = 0.05), double leg stance time (p = 0.04), and vertical ground reaction force (p = 0.04) more than the regular treadmill intervention. The two intervention regimes seem to show little differences in altering the single leg stance time, anteroposterior ground reaction force and impulse, or dynamic gait stability. The findings of this study could provide a foundation for designing effective interventions to improve gait and stability for this population. More studies are needed to investigate the best dosage and long-term and retention effects of the advanced treadmill gait training for people with PD’s gait quality.

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