Researchers suggest that treadmill training with virtual reality helps lower the incidence of falling among Parkinson’s disease patients by changing the brain’s behavior and promoting beneficial brain plasticity.
The study, titled “Disparate Effects of Training on Brain Activation in Parkinson Disease,” and conducted by researchers from Tel Aviv Medical Center, was published recently in the journal Neurology.
“In previous research, we showed that patients with Parkinson’s disease use cognitive function, which is reflected in activation of the pre-frontal cortex of the brain, to compensate for impaired motor function,” says Professor Jeff Hausdorff, from TAU’s Sackler School of Medicine and Tel Aviv Medical Center, in a media release.
“We also showed that a specific form of exercise targeting the cognitive control of gait—combined treadmill training with a Virtual Reality representation of obstacles in a path—leads to a significantly lower fall rate in Parkinson’s patients.
“The Virtual Reality gait program, in which patients must avoid obstacles, enhances the patient’s cognitive performance and thus reduces the requirement for prefrontal brain activity,” he adds.
In the study, 17 subjects in two groups—one that combined treadmill training with virtual reality and one which used treadmill training alone—underwent a 6-week intervention, exercising three times a week for about an hour each time. The virtual reality group played a “game” in which they viewed their feet walking in a city or park environment. Through the game, they implicitly learned how to deal with obstacles in the virtual environment, how to plan ahead and how to do two things at once—that is, address cognitive challenges related to safe ambulation.
The other group just walked on a treadmill without the VR components or cognitive challenges. Before and after the subjects participated in the exercise programs, the researchers used functional MRI imagery to evaluate the patients’ brain activation patterns, the release explains.
“The study’s findings reinforce the hypothesis that training improves motor and cognitive performance through improved neuroplasticity—more so than that seen with treadmill training alone,” Hausdorff states.
“Interestingly, the benefits of treadmill training with VR were specifically seen during walking conditions that require cognitive input (ie, obstacle negotiation and dual tasking), conditions associated with falls in everyday environments. In these conditions, fewer neurons were needed after training with VR, while no change was seen in the group that trained by walking on a treadmill without VR.”
“Exercise that focuses on motor components promotes plasticity in brain areas associated with sensory-motor integration and coordination,” Hausdorff continues. “But exercise incorporating cognitive components also stimulates changes in brain regions related to cognition. It may therefore have a greater impact on compensatory brain function and the cognitive functions related to safe ambulation (ie, walking without falling).”
“The takeaway here is that even relatively late in the disease, when 60-80 percent of dopaminergic neurons have died, there is still an opportunity to promote plasticity in the brain,” he concludes. “Moreover, to induce specific brain changes, exercise should be personalized and targeted to a specific clinical problem.”
[Source(s): American Friends of Tel Aviv University, Science Daily]
