Gait Retraining in Parkinson’s Disease: A Cognitive Cueing Approach

Parkinson's disease (PD) is characterized by resting tremor, bradykinesia, rigidity, and postural instability. These cardinal symptoms commonly affect gait performance and therefore researchers have been investigating techniques to manage and treat gait impairment in individuals with PD. This thesis explores a progressive approach to gait rehabilitation using a novel intervention that combines traditional gait cueing techniques with motor learning approaches to facilitate self-cued gait improvement. Five participants with PD-related gait impairment completed the home-based gait training intervention. This intervention included video footage of each individual participant walking with and without verbal instructional cues, audio coaching, and practice periods. Participants were given the video to practice at home for two-weeks. Kinematic parameters of gait were assessed pre-intervention, at two weeks post-intervention, and at two months post-intervention. Results indicate that individuals with PD are capable of learning verbal-cueing strategies and utilizing these to generate long-term gait improvements through self-cueing. Each of the three co-authors contributed to designing the research methodology used to test the gait retraining intervention highlighted in Chapter 2, and facilitated the process of data collection. Dr. Spaulding also made valuable contributions to the process of data analysis and both Dr. Spaulding and Dr. Jenkins offered valuable improvement to this thesis through the process of iterative editing. Participants in the study (Chapter 2) were recruited from the outpatient neurology practice of Dr. Jenkins, without whose support this project would not have been possible.