Researchers at several institutions have been collaborating on a project aiming to train people with Parkinson’s to shift their balance and overcome ‘freezing of gait’ (a feeling that one’s feet are stuck to the floor).
Funded by Parkinson’s UK, this three-year project, led by Dr William Young (Rehabilitation Psychologist), was based in the School of Sport & Health Sciences (University of Exeter), and was a collaboration with researchers at Brunel University London: Dr Meriel Norris (Physiotherapist) and Dr Elmar Kal (Human Movement Scientist), and KU Leuven: Professor Alice Nieuwboer (Rehabilitation Scientist).
Freezing of gait is associated with balance problems and anxiety; two areas identified, by people with Parkinson’s, as priorities for future research. The £246K Project Grant supported three project phases. First, Cineon Training, a spin out company from Exeter’s Sport & Health Sciences department, have developed training materials for people to learn ‘weight-shifting strategies’. This was achieved through a process of co-design with a team of people who experience freezing, their family members and specialist clinicians.
During the second project phase, the team used the cutting-edge VSimulators research facility to induce freezing in participants and evaluate the potential influence of the weight-shift training on the ability to step from a freeze during a dynamic ‘free navigation task’; where participants walk in a virtual reality environment. They used the facility’s force-sensing platform, which provided unprecedented access to measurements of walking and freeze events that will undoubtedly progress understanding of this common symptom of Parkinson’s.
The research team have also investigated whether the weight-shift training could be safely used to overcome freezing in places where it matters most and when people’s medication has worn off. They have been travelling to visit participants and measure their balance (using discrete wireless shoe insoles) and anxiety-related thoughts (using interviews) in ‘freezing hotspots’.
Throughout this project, the research team have been finding out if weight-shift training is safe and useful, and how thought processes (particularly those relating to anxiety) influence freezing and the ability to use self-taught weight-shifting strategies.
Dr Will Young said: “This project is first and foremost born from the suggestions and ongoing guidance of people with Parkinson’s, their family, friends and carers. This project is about us all working together as a multidisciplinary team and using the state-of-the-art facilities in VSimulators to better understand freezing of gait and develop strategies that are low-cost, effective and practical to use in daily life to help people overcome freezing. We are so grateful to Parkinson’s UK for supporting this research.”
Dr Meriel Norris said: “It is a privilege to be involved in this exciting project with such a varied and outstanding team of researchers. Using state of the art facilities to support the development of everyday solutions for and with people with Parkinson’s is a clinical researcher’s ideal. The team at Brunel are delighted to be part of it.”
Professor Alice Nieuwboer: “I see great opportunities to forge links through this project between the awarded team and my own, both of which are totally dedicated to research in rehabilitation for freezing of gait. Parkinson’s UK made an excellent choice in funding this patient-centered project, which will make a major step forward in our knowledge underpinning robust training approaches for gait difficulties in PD.”
Toby de Burgh of Cineon Training: “We are grateful to be part of this exciting project as it brings together leading researchers and cutting-edge technology in a unique collaboration that has the potential to affect real change in the lives of those affected by this disease.”
Professor James Brownjohn, who led the development of the VSimulators facility, added: “VSimulators is a unique facility providing a core hub for collaboration and inter-disciplinary research between academic communities and commercial partners. This grant is a fantastic opportunity to explore an area for novel research which has the potential to provide real world impact for people with Parkinson’s.”
The support of Parkinson’s UK is gratefully received.