Anat Mirelman, Lynn Rochester, Miriam Reelick, Freek Nieuwhof, Elisa Pelosin, Giovanni Abbruzzese, Kim Dockx, Alice Nieuwboer, Jeffrey M Hausdorff
Overview
Recent studies suggest that fall risk is related to both cognitive and motor deficits. It is true that everyday walking in complex environments requires executive function, dual tasking, planning, and scanning. In a pilot study, treadmill training targeting motor function and virtual reality obstacle courses addressing cognitive components of fall risk were combined to successfully address the motor-cognitive interactions that are fundamental for fall risk reduction. A randomized controlled trial with virtual reality will evaluate the effects of treadmill training on fall risk.
Methods/Design:
Participants in this study will be 300 older adults who have experienced falls. The sample will include older adults (n=100), patients with mild cognitive impairment (n=100), and patients with Parkinson’s disease (n=100). We will recruit these three sub-groups in order to evaluate the effect of the intervention in people with a range of motor and cognitive deficits. Subjects will be randomly assigned to either the intervention group (treadmill training with virtual reality) or the active-control group (treadmill training without virtual reality). Participants will attend an outpatient training program 3 times a week for 6 weeks. Before, after, and one month and six months after the training, assessments will be conducted. Each participant will keep a falls calendar for 6 months after completing the training to assess fall incidence (i.e., the number of falls, multiple falls, and falls rate). We will also measure gait under usual and dual task conditions, balance, community mobility, health related quality of life, user satisfaction and cognitive function.
Discussion:
An intervention that combines treadmill training with virtual reality will be assessed to see whether it reduces falls, improves mobility and improves cognitive function in a diverse group of older adults. The comparison to a control group that undergoes treadmill training without virtual reality will also demonstrate the added value of addressing motor cognitive interactions as a whole.
GaitBetter implements the V-TIME academic research project that led to many of these papers on a commercial basis.