Turning around Freezing: Effect of split-belt treadmill training on daily-life turning-related freezing of gait in Parkinson’s disease

Turning difficulties are common in people with Parkinson’s disease (PD) and often lead to falls or to blocks in movement known as freezing of gait (FOG). Both FOG and falls are difficult to elicit in a laboratory setting, but frequently occur in daily life while people are multi-tasking. Previous work by our group has shown that split-belt treadmill training (SBT) improves turning while multi-tasking and reduces FOG in the laboratory. However, whether these effects transfer to daily life is not yet known. This study will use wearable sensors to monitor turning behavior in daily life and study the effects of a combined training mode, the so-called SBT+ intervention. SBT+ will complement traditional SBT with over-ground complex practice to enhance transfer, thereby enlarging its clinical benefit. We will compare SBT+ with a control period without intervention. We expect that SBT+ will improve daily life turning and reduce FOG severity and fall risk. Overall, in this project we will gain insight in the crucial bridge towards clinical implementation of a novel rehabilitation method and as such generate new knowledge on how technical innovation can be employed to ameliorate safer gait in everyday life.