First-trial protective step performance before and after short-term perturbation practice in people with Parkinson’s disease

J. S. Barajas, Daniel Peterson

    Research output: Contribution to journalArticlepeer-review

    12 Scopus citations


    Background: Protective steps are critical for fall prevention and are altered in people with Parkinson’s disease (PD). Previous work suggests that perturbation training, in which patients are exposed to repeated slips, may improve protective postural responses. However, these studies typically take the average performance of several postural responses before and after training. To reduce falls in the community, training must improve protective stepping after the first perturbation exposure. To date, no investigations have examined whether first-trial protective stepping is improved after training in people with PD. Methods: First-trial protective stepping was measured in 14 people with PD and 9 healthy adults before and 24 h after 1 day of perturbation training. The primary outcome was margin of stability after a perturbation, a measure of protective stepping effectiveness. Results: Margin of stability for the first perturbation was significantly (p = 0.001) improved on day 2 compared to before perturbation practice (day 1) in both groups. Furthermore, improvement in margin of stability was correlated with age and baseline stepping performance, such that older individuals and people with worse baseline performance showed the most pronounced improvement. Conclusions: Improving the first loss of balance after training is critical if such training is to reduce falls in people with PD. The observed improvement in first-trial protective stepping provides further support for perturbation training as a potential tool to improve protective steps and reduce falls in people with PD.

    Original languageEnglish (US)
    Pages (from-to)1138-1144
    Number of pages7
    JournalJournal of Neurology
    Issue number5
    StatePublished - May 1 2018


    • Falls
    • First trials
    • Parkinson’s disease
    • Perturbation training
    • Reactive stepping

    ASJC Scopus subject areas

    • Neurology
    • Clinical Neurology


    Dive into the research topics of 'First-trial protective step performance before and after short-term perturbation practice in people with Parkinson’s disease'. Together they form a unique fingerprint.

    Cite this