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This Issue: The Aging Veteran | Table of Contents: Summer 2016 |

Spotlight on Career Development awardees

New directions in Parkinson's disease rehab

Veteran Patrick Adams, seen here with Dr. Mon S. Bryant, took part in a study on multidirectional treadmill training. (Photo by Shawn James)</em>
Veteran Patrick Adams, seen here with Dr. Mon S. Bryant, took part in a study on multidirectional treadmill training. (Photo by Shawn James)

Veteran Patrick Adams, seen here with Dr. Mon S. Bryant, took part in a study on multidirectional treadmill training. (Photo by Shawn James)

Starting with this issue, each issue of VARQU will highlight the work of a current VA Career Development awardee. The highly competitive program offers top-caliber junior scientists salary and research funding, along with mentored training and other scientific and administrative support.

Dr. Mon S. Bryant is a research health scientist at the Michael E. DeBakey VA Medical Center in Houston, and an assistant professor in the department of physical medicine and rehabilitation at Baylor College of Medicine. She is a recipient of a VA Career Development Award for her innovative work on the rehabilitation of Veterans with Parkinson's disease (PD).

VARQU: Please tell us briefly about your Career Development project.

Bryant: The aim of my project is to study the effectiveness of multidirectional treadmill training [MDTT] in improving walking and balance in Veterans with Parkinson's disease.

How did you become interested in this topic?

I have a background in neurological rehabilitation, and am a licensed physical therapist. I have worked a lot with neurological patients who have problems with mobility, walking and balance. I've also been involved in Parkinson's research for quite some time. Walking and balance impairment is always a major concern in these patients because they are very common symptoms. Almost every patient will experience these issues during the duration of the disease, at certain degrees of impairment.

When they have PD they are likely to fall, and falls affect their quality of life and functional ability. That's why I am interested. I want to find effective training to help these patients.

What is multidirectional treadmill training?

This is an innovative training that we use. On the treadmill, the Veterans walk forward, backward, sideways to the left, and sideways to the right. This challenges their balance in multiple directions. We encourage the Veterans to walk with long strides at the fastest speed they can tolerate. Patients with Parkinson's have a short stride length, so we use the training on the treadmill to induce a more normal stride in these patients. During the training, the patients are fitted with a safety harness that attaches to a support system positioned over the treadmill to prevent falling.

What is the current status of the project?

We are in the second phase of the study, and the entire study will be completed next year [in 2017]. So far, we've found that six weeks of training is the optimal training period to improve walking and balance. In the second phase, we're using six weeks as the duration of the training. Now, we are looking at changes in their Parkinson's symptoms and changes in walking, and making quantitative measures of their balance and walking abilities.

How do you think the results of the study will help Veterans?

This will help Veterans with Parkinson's disease, because Veterans who participate in the project will get the benefit of the training, and our findings can be generalized to other Veterans who have similar problems. Clinicians and physical therapists will be able to look at our study and start using this kind of training with their clients.

What do you plan to do afterward?

There are a couple of directions we can go in after this study. One is that we can apply the MDTT in other Veterans who have problems with stability, such as those with neurological conditions like ataxia, or cerebellar dysfunction. Or we can use it with frail elderly Veterans, to prevent them from falling and to improve their stability. The second direction is that I want to compare the MDTT to see if it is better than just conventional walking on a treadmill.

With Parkinson's patients, our rehabilitation goal is to delay or minimize functional disability—to have them walk independently for as long as they can with safety. That's our ultimate goal. Therefore, my research goal is to find the most effective approach for the patients to achieve that.

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