Study Rationale:
People with Parkinson's disease often experience falls, which can have serious consequences. Falls may be caused by gait impairments, postural instability and freezing of gait (FOG), which current medical options may not fully prevent. Scientific evidence suggests rhythmic cues can help by providing an external trigger. This can address many mobility impairments that remain highly resistant to conventional therapies. Our program, StandingTall-PD, meets this need with an effective, affordable and scalable self-managed neuro-rehabilitation program for people with Parkinson's. The four-week program works by synchronizing three different external cues (e.g., visual, auditory and touch) to reduce gait impairments and FOG and therefore prevent falls.
Hypothesis:
We hypothesize that our intensive neuro-rehabilitation program combined with continuation of care can improve mobility, reduce freezing of gait and prevent falls in people with Parkinson's.
Study Design:
We plan a clinical trial in 106 people with Parkinson's. Participants will be randomized to the intervention (n=53) or placebo (n=53) groups. The intervention group participants will receive the StandingTall-PD intensive neuro-rehabilitation program. The placebo group participants will receive two pairs of non-slip socks. Participants in both groups will receive usual medical care from their treating physicians and the Staying Active and on Your Feet educational booklet. After four weeks, we will assess reductions in gait impairments and freezing of gait and improvements in mobility. After six months, we will assess reductions in number of falls experienced and improvements in mental well-being and quality of life.
Impact on Diagnosis/Treatment of Parkinson's disease:
StandingTall-PD could transform the management of gait impairments in people with Parkinson's. The program includes individually tailored tools to empower people with Parkinson's to manage their symptoms, increase their capacity to remain independent and enjoy the highest possible quality of life.
Next Steps for Development:
Our goal is to make StandingTall-PD the leading eHealth solution for maximizing mobility and preventing falls in people with Parkinson's. If successful, we could make StandingTall-PD available to people with Parkinson's upon completion of this project. The global uptake of mobile technology makes our user-friendly product suitable for widespread use.