Novel Robotics-Treadmill-Platform Application To Improve Walking In A Person With Parkinson's Disease: A Case Report

Abstract

<h3>Research Objectives</h3> Illustrate the potential benefits of a 6-week novel Robotic treadmill system training protocol, focused on implicit learning of challenging tasks, on walking performance in an older adult with Parkinson's Disease. <h3>Design</h3> A single-subject case report. <h3>Setting</h3> Outpatient rehabilitation clinic in the southwestern U.S. <h3>Participants</h3> An 82-year-old-female with a 3-year history of Parkinson's disease (PD) on carbidopa/levodopa (Hoehn and Yahr stage 1) was referred to physical therapy (PT) to improve performance and safety of walking. <h3>Interventions</h3> Twelve twice-weekly PT sessions on the walking robotics platform (KineAssist). The platform allows "self-driven"/intentional movement on the treadmill with body weight support, catching after loss of balance, and including full freedom of movement. The protocol emphasized progressive Endurance, Strength, Speed, and Perturbation exercises individualized to her abilities. <h3>Main Outcome Measures</h3> . The primary outcomes were the overground 6-Min-Walk Test (6MWT), TUG, TUG Carry, TUG Cognitive, and Mini-Best test. Secondary outcomes included 10-Meter-Walk-Test (10MWT) self-selected and max walking speeds assessed via the Robotic treadmill system. <h3>Results</h3> The 6MWT improved 51% (318-481m); the TUG score improved 53% (10.3-5.5 sec); the TUG Carry, 50% faster (13.7- 6.8 sec); the TUG Cognitive, 50% faster (13.2- 6.5 sec), the Mini-Best Test improved 8 points (18/28-26/28). The self-selected 10MWT speed improved 196% (0.27- 0.8 m/s) and max gait speed by 120% (1.0-2.2 m/s). <h3>Conclusions</h3> An individualized robotic treadmill gait training protocol was used successfully with an older patient with PD, with marked improvement in her walking, exceeding available minimal clinically important distances for all outcome measures. An implicit learning approach, combined with a robotic treadmill, may enable individuals to perform challenging tasks without fear of physical harm and to develop strategies for safe mobility in their environment. <h3>Author(s) Disclosures</h3> The authors declare that they have no relevant or material financial interests related to the research described in this abstract. Dr. Brown is a Co-inventor of a device described in the presentation, but he currently DOES NOT receive any royalties.