Objective: This study aimed to examine the effect of reaction-oriented training (ROT), a novel rehabilitation approach developed for people with Parkinson’s disease (pwPD), on postural stability (PS) and reaction time (RT).

Background: Most evidence-based exercise approaches used for pwPD, such as task-oriented training and LSVT BIG, involve exercise training with an internal focus, which may have limited benefit for pwPD [1], given the decreased speed and range of motion during exercise due to bradykinesia [2]. Therefore, there is a need for an external focus-based approach like ROT, which aims to improve speed and range of motion through external targets.

Method: Ten pwPD participated in this randomized controlled clinical trial. Participants were equally assigned to the ROT and control groups (CG). The disease stage was evaluated using the Modified Hoehn-Yahr Scale, PS was assessed with the K-invent® Force Platform, and RT was evaluated with the Blazepod® System. The ROT group underwent exercise training at a maximum range of motion and maximum speed using the Blazepod® system. The same exercise stations were applied conservatively to the CG. Participants attended the rehabilitation program twice a week for 6 weeks.

Results: The descriptive data of the groups were similar. The ROT group showed significant improvement in simple and selective RT of extremities, ellipse area in both eyes-open and eyes-closed conditions, and the Romberg coefficient (p<0.05). In the CG, significant improvement was found in the upper extremity simple RT (p<0.05). When the differences between pre- and post-intervention data were compared, a significant difference was observed in upper extremity selective RT (p=0.03), lower extremity simple (p=0.03) and selective RT (p=0.008), ellipse area in eyes-closed condition (p=0.05), and the Romberg coefficient (p=0.03), favoring the ROT group [Table1].

Conclusion: Reaction-oriented training is a structured, contemporary approach designed to enhance speed and range of motion through an external focus. Despite the small sample size, these preliminary results demonstrated its superiority over the conservative rehabilitation approach for PD, suggesting that ROT may be a promising rehabilitation approach for PD. Additionally, it could serve as a foundation for future external focus-based rehabilitation approaches for PD.

Data on pre- and post-intervention differences

References: 1- Kakar, C., Zia, N., Sehgal, S., & Khushwaha, S. (2013). Effect of external and internal focus of attention on acquisition, retention, and transfer phase of motor learning in Parkinson’s disease. Hong Kong Physiotherapy Journal, 31(2), 88-94.
2- Herz, D. M., & Brown, P. (2023). Moving, fast and slow: behavioural insights into bradykinesia in Parkinson’s disease. Brain, 146(9), 3576-3586.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-reaction-oriented-training-on-postural-stability-and-reaction-time-in-parkinsonss-disease/