Lehman, D.A.; Florida State University, Tallahassee, Florida and University of St. Augustine, St. Augustine, Florida. DLehman@usa.edu.

PURPOSE: 1) To determine if an instructional set will significantly improve the step length of people with Parkinson’s disease, 2) to determine the durability of the intervention’s effects, and 3) to determine if changes in gait remain when participants walk while performing a secondary task. SUBJECTS: Eleven individuals with early stage Parkinson’s disease were randomly assigned to a treatment group (n = 5) or a control group (n = 6). METHODS: The treatment group participated in a 10-day program that consisted of walking 1800 feet (3 sets of 600 feet) per day and with the instructions to, "Take long steps". The instructions were repeated to the participant every 60 feet. No feedback was provided. Testing occurred prior to treatment, at the end of treatment, one-week after treatment, and one month after treatment. Testing included four conditions: 1) Walking without a secondary task and without cueing, 2) Walking while performing a secondary task and without cueing, 3) Cued walking without performing a secondary task, and 4) Cued walking while performing the secondary task. The order of condition was counter-balanced. Each participant performed three trials for each condition. The secondary task required repetition of, "Work in the garden until you have picked all the beans." ANALYSIS: The use of a 2 (Group) x 2 (No Cue/Cue) x 2 (No Task/Task) x 4 (Time) ANOVA with repeated measures on the last three factors determined if there were significant interactions. Tukey HSD post-hoc analysis determined the significant differences between individual means. RESULTS: The results indicate that there was a significant interaction between the Groups by Time by No Task/Task condition, F (3, 27) = 3.127, p = .042, eta² = .258, power = .661. For both No Task and Task conditions; 1) step length of the treatment group significantly increased between baseline and all three post-tests, 2) a significant difference between the treatment group and control group at all post-tests. Between the No Task and Task conditions; 3) a significant difference for both groups at baseline and the first post-test and, 4) a significant difference at post-test two for the treatment group. The step length of the treatment group when performing a secondary task was significantly better than the step length of the control group when they were not performing the secondary task. CONCLUSIONS: The instructional set was effective in improving step length for at least four weeks. A change may have occurred within the automatic program of gait. Both findings may lead to increased safety and activity level for people with Parkinson’s disease. FUNDING SOURCE: Florida State University and University of St. Augustine.

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