Understanding balance and walking in Parkinson’s disease

Stephanie Tran
PhD Student
University Health Network
Graduate Student Award
$20,000 over 2 years
Characterizing the effects of Parkinson’s disease on multisensory integration for balance

Poor balance and difficulty walking are symptoms of Parkinson’s disease that are difficult to treat, because they don’t respond to medication that can improve other movement symptoms.

At Toronto’s University Health Network, PhD student Stephanie Tran has zeroed in on the sensory systems involved in balance to learn what contributes to the walking problems in Parkinson’s disease.

Tran first began examining standing balance and the vestibular system while earning her Master’s degree; now she’s delving in deeper.

“I realized there are so many questions we have about the sensory side of balance and walking in Parkinson’s disease,” she says.

There are three main sensory systems involved in balance: sight, proprioception (the sense of knowing where your limbs and body are in space), and the vestibular system inside the inner ear, which tells you where your head is in space.

Tran wants to understand what’s going wrong with all of these systems and how the brain receives, adjusts and feeds sensory information back to people as they walk.

“There are so many questions we have about the sensory side of balance and walking in Parkinson’s disease.”

She’s recruiting 15–20 people with Parkinson’s disease and the same number of healthy elderly people for her study. Tran will use simulations to change what people with Parkinson’s disease see, feel in their limbs, and the information they receive in their inner ear.

Using cameras, she’ll record the way they walk on the treadmill as the information they are getting through their sensory systems changes, to try to see how each system contributes to balance and walking.

She wants to discover which system people with Parkinson’s rely upon the most to help them balance.

“People with Parkinson’s respond better if you give them lots of visual cues, like lines to step over,” she says. “What we don’t know, for example, is how the vestibular system contributes.”

Once she knows how each system contributes, Tran will create new cues to help people improve their balance, such as pairing visual and vestibular information together.

“Right now there is limited treatment for Parkinson’s balance and gait. What I want to see is whether this is a way I can use sensory information to improve walking.”

Tran loves the combination of patient contact and practical research that working in the Parkinson’s field gives her.

“I’m really committed to figuring out ways to improve quality of life,” she says.