Two weeks of twice-daily prism adaptation treatment does not improve posture or gait in Parkinson’s disease: a double-blind randomized controlled trial

Abstract Background Gait difficulties in Parkinson’s disease have been related to problems shifting the center of gravity forward. We previously showed reduced forward stepping latencies for people with Parkinson’s disease after one session of adaptation to upward visual shifts, which produces downw...

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Autores principales:	Janet H. Bultitude, Dawna M. Pidgeon, Pauline R. LeBlanc, Charlotte A. Jeffreys, Faith P. Alexandre, Stephen L. Lee
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Parkinson’s disease Prism adaptation Gait Rehabilitation Clinical trial Freezing of gait Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/9331bc37513e413aa2559d16ccbf0b10
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spelling	oai:doaj.org-article:9331bc37513e413aa2559d16ccbf0b102021-11-28T12:28:34ZTwo weeks of twice-daily prism adaptation treatment does not improve posture or gait in Parkinson’s disease: a double-blind randomized controlled trial10.1186/s13063-021-05832-21745-6215https://doaj.org/article/9331bc37513e413aa2559d16ccbf0b102021-11-01T00:00:00Zhttps://doi.org/10.1186/s13063-021-05832-2https://doaj.org/toc/1745-6215Abstract Background Gait difficulties in Parkinson’s disease have been related to problems shifting the center of gravity forward. We previously showed reduced forward stepping latencies for people with Parkinson’s disease after one session of adaptation to upward visual shifts, which produces downward motor after-effects and potentially shifts the center of gravity forward. Here we tested if repeated prism adaptation improved gait and postural control in Parkinson’s disease through a parallel, double-blind, randomized, sham-controlled trial. Methods We recruited participants with idiopathic Parkinson’s disease aged 40–85 and meeting any one of three clinical criteria: (1) Hoehn and Yahr Stage II.5–IV; (2) scoring > 0 on the gait, freezing of gait, and/or postural stability items of the Movement Disorder Society Unified Parkinson’s Disease Rating Scale; or (3) Timed Up and Go > 12 s. Sealed envelope style randomization allocated participants to two weeks of twice-daily prism adaptation or sham treatment. Participants, care givers, and those assessing the outcomes were blinded to group assignment. Primary outcomes were changes in postural control measured using the Berg Balance Scale and the Limits of Stability, Sensory Organization, and Motor Control tests from the Smart EquiTest system. Secondary outcomes included other physiotherapy and questionnaire measures. Outcomes were assessed at the Dartmouth Hitchcock Medical Center immediately before and after the treatment period, with further long-term postal follow-up over 3 months. Outcomes were analyzed using analyses of variance with follow-up t tests. Results Eighteen participants were allocated to undergo prism adaptation, of which sixteen were analyzed. Thirteen participants were allocated to undergo sham treatment, and all were analyzed. The prism adaptation group showed increased forward stepping velocity on the Limits of Stability test (pre: M=2.33, SEM=0.24; post: M=2.88, SEM=0.26; t(15)=3.2, p=.005, d=.819). The sham group showed no such change (pre: M=2.13, SEM=0.22; 1d post: M=2.24, SEM=0.22; t(13)=.636, p=.537, d=.176). However, there were no group differences for any other outcome measures and no indications that prism adaptation produced functional improvements in posture, gait, or activities of daily living. Conclusions Prism adaptation does not improve gait or postural control in Parkinson’s disease. Trial registration ClinicalTrials.gov NCT02380859 . Registered prospectively on 5 March 2015.Janet H. BultitudeDawna M. PidgeonPauline R. LeBlancCharlotte A. JeffreysFaith P. AlexandreStephen L. LeeBMCarticleParkinson’s diseasePrism adaptationGaitRehabilitationClinical trialFreezing of gaitMedicine (General)R5-920ENTrials, Vol 22, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Parkinson’s disease Prism adaptation Gait Rehabilitation Clinical trial Freezing of gait Medicine (General) R5-920
spellingShingle	Parkinson’s disease Prism adaptation Gait Rehabilitation Clinical trial Freezing of gait Medicine (General) R5-920 Janet H. Bultitude Dawna M. Pidgeon Pauline R. LeBlanc Charlotte A. Jeffreys Faith P. Alexandre Stephen L. Lee Two weeks of twice-daily prism adaptation treatment does not improve posture or gait in Parkinson’s disease: a double-blind randomized controlled trial
description	Abstract Background Gait difficulties in Parkinson’s disease have been related to problems shifting the center of gravity forward. We previously showed reduced forward stepping latencies for people with Parkinson’s disease after one session of adaptation to upward visual shifts, which produces downward motor after-effects and potentially shifts the center of gravity forward. Here we tested if repeated prism adaptation improved gait and postural control in Parkinson’s disease through a parallel, double-blind, randomized, sham-controlled trial. Methods We recruited participants with idiopathic Parkinson’s disease aged 40–85 and meeting any one of three clinical criteria: (1) Hoehn and Yahr Stage II.5–IV; (2) scoring > 0 on the gait, freezing of gait, and/or postural stability items of the Movement Disorder Society Unified Parkinson’s Disease Rating Scale; or (3) Timed Up and Go > 12 s. Sealed envelope style randomization allocated participants to two weeks of twice-daily prism adaptation or sham treatment. Participants, care givers, and those assessing the outcomes were blinded to group assignment. Primary outcomes were changes in postural control measured using the Berg Balance Scale and the Limits of Stability, Sensory Organization, and Motor Control tests from the Smart EquiTest system. Secondary outcomes included other physiotherapy and questionnaire measures. Outcomes were assessed at the Dartmouth Hitchcock Medical Center immediately before and after the treatment period, with further long-term postal follow-up over 3 months. Outcomes were analyzed using analyses of variance with follow-up t tests. Results Eighteen participants were allocated to undergo prism adaptation, of which sixteen were analyzed. Thirteen participants were allocated to undergo sham treatment, and all were analyzed. The prism adaptation group showed increased forward stepping velocity on the Limits of Stability test (pre: M=2.33, SEM=0.24; post: M=2.88, SEM=0.26; t(15)=3.2, p=.005, d=.819). The sham group showed no such change (pre: M=2.13, SEM=0.22; 1d post: M=2.24, SEM=0.22; t(13)=.636, p=.537, d=.176). However, there were no group differences for any other outcome measures and no indications that prism adaptation produced functional improvements in posture, gait, or activities of daily living. Conclusions Prism adaptation does not improve gait or postural control in Parkinson’s disease. Trial registration ClinicalTrials.gov NCT02380859 . Registered prospectively on 5 March 2015.
format	article
author	Janet H. Bultitude Dawna M. Pidgeon Pauline R. LeBlanc Charlotte A. Jeffreys Faith P. Alexandre Stephen L. Lee
author_facet	Janet H. Bultitude Dawna M. Pidgeon Pauline R. LeBlanc Charlotte A. Jeffreys Faith P. Alexandre Stephen L. Lee
author_sort	Janet H. Bultitude
title	Two weeks of twice-daily prism adaptation treatment does not improve posture or gait in Parkinson’s disease: a double-blind randomized controlled trial
title_short	Two weeks of twice-daily prism adaptation treatment does not improve posture or gait in Parkinson’s disease: a double-blind randomized controlled trial
title_full	Two weeks of twice-daily prism adaptation treatment does not improve posture or gait in Parkinson’s disease: a double-blind randomized controlled trial
title_fullStr	Two weeks of twice-daily prism adaptation treatment does not improve posture or gait in Parkinson’s disease: a double-blind randomized controlled trial
title_full_unstemmed	Two weeks of twice-daily prism adaptation treatment does not improve posture or gait in Parkinson’s disease: a double-blind randomized controlled trial
title_sort	two weeks of twice-daily prism adaptation treatment does not improve posture or gait in parkinson’s disease: a double-blind randomized controlled trial
publisher	BMC
publishDate	2021
url	https://doaj.org/article/9331bc37513e413aa2559d16ccbf0b10
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Two weeks of twice-daily prism adaptation treatment does not improve posture or gait in Parkinson’s disease: a double-blind randomized controlled trial

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