Effects of Technology-Based Perturbation Training During Walking on Physical Function in Stroke, Multiple Sclerosis, and Parkinson's Disease: A Scoping Review.
Heli Lahtio, Raija Kulmala, Lari Saastamoinen and 2 others
No clear advantage was found for technology-based perturbation training over similar non-perturbation walking in stroke, MS, or PD.
The perturbation group did show improvements, but the evidence is preliminary and the studies were small and heterogeneous.
Key findings
1No clear between-group differences were identified for any specific outcome across the three neurological disorders when perturbation training was compared with similar training without the perturbation feature.
2Within the perturbation group, statistically significant improvements were observed in balance measures in stroke, postural response latency in MS, and gait variability parameters in PD.
3The median intervention was 3 weeks with 3 sessions per week of approximately 25 minutes each, and seven different technologies were used across the studies.
Still to come
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 10 studies were included, and four of them (all in PD) used the same dataset, so they do not represent four independent pieces of evidence. Sample sizes in the individual studies were small, ranging from 11 to 18 in the experimental group and 10 to 20 in the control group. Intervention content was extremely heterogeneous: seven different technologies, durations from 1 day to 8 weeks, and different progression strategies, making it hard to compare or combine results. The vote-counting synthesis can show the direction of effects but cannot determine whether the differences are clinically meaningful. Selection bias is possible because perturbation training during walking was not always clearly labelled in the original studies, and terminology in the literature is inconsistent. Only English-language studies were included.
Declared interests
One author (A.R.) was funded by the Research Council of Finland (grant 360087). The authors declared no other conflicts of interest.
The easy way to misread this
Do not read the within-group improvements as proof that perturbation training beats regular walking training. The between-group comparisons were largely null, and four of the ten studies all used the same Parkinson's disease dataset, so they do not represent four independent pieces of evidence.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →