PILOT STUDY:  ARE VISUAL MARKERS IN THE HOME ENVIRONMENT

EFFECTIVE IN IMPROVING PARKINSONIAN GAIT?

Frank LM, Riley N, Swanson C, Trapkus J

Physical Therapy Program, St. Ambrose University, Davenport, Iowa

Background and Purpose.  People with Parkinson’s disease continually struggle with progressively deteriorating motor skills due to basal ganglia dysfunction.  These deteriorating motor skills can have profound effects on locomotion producing a festinating gait with short stride length, increased cadence, and decreased velocity.  Various forms of visual cueing have been used to initiate improvements in these gait parameters.  The purpose of this case report is to evaluate the effectiveness of visual markers placed on the floor in the home environment.  Two weeks of training with visual cues was followed by a two week period without visual cues in order to assess carryover.  Case Descriptions.  Two subjects were included in this study.  Subject 1 was rated Stage II on Hoehn and Yarr’s classification system.  She complained of occasional loss of balance during high level activities.  Subject 2 was rated Stage III on the Hoehn and Yarr scale.  He complained of bradykinesia.  Outcomes.  At the completion of this study, Subject 1 demonstrated increased stride length, decreased cadence, and increased velocity.  She continued to show improvements after visual cues were removed.  Subject 2 demonstrated decreased stride length, increased cadence, and decreased velocity.  He was unable to use the visual cues independently.  Discussion.  Our results show that this treatment may produce variable responses.  Some subjects may require permanent visual cues while others may retain the benefits of visual cues in their absence.  It is the physical therapist’s responsibility to decide whether visual cues provide appropriate functional treatment.  Further research is needed to determine the statistical significance of home based visual cue treatment.

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