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Effect of postural perturbation training on the ability to recover body balance in individuals with Parkinson's disease with freezing of gait


The risk of critical body disequilibrium and subsequent fall is relatively high in advanced stages of Parkinson's disease, particularly when freezing of gait is established. This project aims to evaluate the effect of training of body balance recovery following unanticipated perturbations in individuals with freezing of gait due to Parkinson's disease. Postural perturbations will be generated by means of controlled translations and rotations of the support base, through an electronic movable platform. The experimental group will receive training with progressive perturbations on the movable platform. Balance perturbations will be applied through unanticipated translations and rotations of the support base, in the anteroposterior and mediolateral axes, in either directions, and in different velocities. The control group will perform physical exercises to improve muscular endurance, with minimal requirement of body balance. The training for both groups will be developed in 8 sessions, during a period of 4 weeks. Assessments will be made immediately prior to the beginning of training, and 48 h and 30 days after the last session of training. The primary outcome will be based on the recovery of post-disturbance body balance on the movable platform, including dual task (cognitive) tasks and transfer to more challenging equilibrium disturbances (higher velocity of platform displacement). Analysis will be made kinematic variables, including center of mass displacement and variation of the vertical orientation of the trunk, as well as scores from qualitative analysis of postural responses. Secondary outcomes will be performance on the MiniBestTest scale, sequential body turning in place, and questionnaire/inventory analysis of the training effects on falls/near-falls, freezing of gait and fear of falling in daily living activities. (AU)

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