Parkinson’s disease (PD) currently affects over 10 million people worldwide, and 200,000 Australians live with the disease, while another 38 are diagnosed every day.

70 per cent of PD patients also deal with unstable gait and falls, which for many contributes to loss of confidence, social isolation, fractures and increased hospital admissions.

Treadmill training has demonstrated significant benefits in improving gaits and reducing falls, which can be enhanced by using mechanical or virtual-reality triggered gait adaptations at the same time. Unfortunately, the underlying mechanisms responsible remain poorly understood, which can result in suboptimum care.

Shake It Up Australia is proud to be an associate partner and a key stakeholder to the 2023 NHMRC-EU Joint Programme on Neurodegenerative Disease Research, titled “Taking steps against the burden of Parkinson’s disease”. The research program, which aims to improve fall prevention in people with Parkinson’s disease, will study the biomechanical, physiological, and neural changes that underly intervention success.

Dr Matthew Brodie, Senior Lecturer Health Informatics and Biosignal Processing at the University of New South Wales, says:

“Treadmill training is a great form of exercise for people with mild to moderate Parkinson’s disease that can be completed in the comfort of the home environment. However, little is known about the underlying neurophysiological and psychosocial mechanisms responsible and why some people may respond better to training than others. This project seeks to develop enhanced treadmill training protocols targeting gait impairment in people living with Parkinson’s disease through the concurrent use of mechanical or virtual-reality triggered gait adaptations.

What’s Involved

Four clinical centers (Sydney, Tel Aviv, Bologna and Kiel) will recruit 168 PD patients, randomised 1:1 to intervention or control groups. The intervention will receive treadmill training, enhanced by mechanically or virtual-reality triggered gait adaptations. All participants will undergo assessments before, immediately after training, and at 12-weeks to investigate retention. We expect gait speed, step length and step variability to improve by clinically relevant extents. The research team hypothesises that sensorimotor integration underpinning feedback control of balance during gait will be improved and that gait efficacy will mediate the transfer of training effects to daily-life gait. Biomechanical, neurophysiological, social and psychological mechanistic changes underpinning intervention success will be assessed with a combination of advanced state-of-the-art techniques.

This EU Joint Project will provide a mechanistic understanding of how widely used treadmill training changes neural activity in PD patients, how this translates to improved control of gait, and how this in turn translates to outcomes that are meaningful to patients in their daily life.

Dr Brodie says, “This consortium provides new opportunities for UNSW’s Graduate School of Biomedical Engineering to play a leading role in international efforts to slow, stop and find a cure for Parkinson’s disease. Shake It Up Australia Foundation’s involvement will help focus our research efforts on outcomes that provide direct and immediate benefits to people with Parkinson’s disease.”

Dr Matthew Brodie

The Sydney centre, led by Dr Matthew Brodie of UNSW, includes Professor Nigel Lovell (Head of UNSW’s Graduate School of Biomedical Engineering), Dr Yoshi Okubo from Neuroscience Research Australia, and Dr Martin Ostrowski from UTS.