Individuals with Parkinson’s disease commonly experience gait and balance disorders that contribute to falls, mobility loss, and reduced independence and quality of life.
Although most falls among Parkinson’s patients occur during walking, current research has primarily focused on patients’ response to balance perturbations while standing.
In an effort to fill this gap, Columbia neurologists and engineers are using a robotic device to investigate how Parkinson’s affects the ability to walk and respond to balance perturbations.
The robotic device – called Active-Tethered Pelvic Assist Device (A-TPAD) – is a wearable, lightweight cable-driven robot that can be programmed to push or pull the pelvis in a desired direction as a person walks on a treadmill.
Dr. Sunil Agrawal and team designed the device and have been working with Lan Luo, MD, Movement Disorders Fellow; Un Jung Kang, MD, chief of the Division of Movement Disorders; and Stanley Fahn, MD, director emeritus of Columbia’s Center for Parkinson’s Disease and Other Movement Disorders, to test the device with patients.
In their most recent study – published in Scientific Reports – the investigators used the device to analyze, for the first time in Parkinson’s patients, the effects of multidirectional perturbations of different amplitudes delivered while walking.
The researchers found reduced stability and an inability to produce proactive anticipatory adjustments among patients, but the ability to adapt to multiple perturbations or to modify responses to changing amplitudes or directions was comparable to a group of healthy subjects.
As reported by Columbia Engineering, both groups improved their unperturbed walking after a single training session with repeated waist-pull perturbations.
“A-TPAD provides both insight into the specific mechanisms underlying the propensity of Parkinson’s patients to fall and a novel tool to train them to avoid falls,” says Dr. Kang.
“The potential of such training to prevent accompanying morbidity from the falls and to improve their quality of life is great.”