Ongoing Projects

Freezing of gait (FOG) is a debilitating symptom of Parkinson's disease (PD) that eventually affects up to 80% of persons in advanced stages of PD. FOG can also reduce quality of life and independence and increase the risk of falling. Despite the prevalence of FOG, there is currently no gold standard clinical assessment which thereby hinders advancements in therapeutic treatments. This study aims to address the lack of global standardization in assessing freezing of gait and the ability to evaluate therapeutic improvement of this symptom.

This study involved up to two sessions spaced 1–2 weeks apart, a take-home movement monitor, and an optional follow-up online interview. Each in-person session took approximately 3 hours to complete. During this time, participants were asked to complete a short movement assessment involving different variations of walking and turning. This movement assessment was performed prior to and after taking the participant's morning Parkinson’s medication. The participant was asked to complete questionnaires, which asked about: Parkinson’s symptoms, mental health, demographics (e.g. age, sex, education, living arrangements etc.), general health (falls, falls related injuries, smoking, alcohol consumption).

Project lead: Dr. Erika Howe

Stage of study: Analysis

Anxiety is one of the most common non-motor symptoms experienced in Parkinson’s and impacts daily living and can intensity PD symptomology and movement performance. It has not been understood specifically how symptoms of anxiety or stress relate to sensory deficits, and whether this may interact with movement behaviour. The proposed research will focus on understanding how changes within the sensory system might contribute to anxiety and interfere with movement control in patients with PD.

This study was held at the University of Waterloo and took approximately 3 hours. Participation in this study involved filling out questionnaires about various aspects of movement and behaviour that may impact day-to-day life. During the study participants performed walking tests both in and out of different virtual environments by wearing a virtual reality headset. During these walking tasks, we measured heart rate and sweat responses. We also performed a few tests to assess balance and sensory system. 

Project lead: Dr. Erika Howe

Stage of study: Analysis

Our previous research found that the current tests available to measure walking and balance problems in PD are not good enough to measure all these balance aspects at once. The current study aims to validate a new scale, called the “Movement Disorders Society Rating Scale: Postural Instability and Gait Difficulties (PIGD)”. This scale will measure walking, balance, posture, and fear of falling in people with PD.

This study involved one session that took approximately 75 minutes to complete. During this visit, patients were asked to perform some movement tasks involving their limbs, as well as tasks that assess posture, balance, and walking. Some of the balance tasks involved the researcher holding the person while allowing them to lean, and subsequently letting go, or briskly pulling on their shoulders to assess how well you recover your balance. The patient's goal will be to accomplish the movement tasks as quickly and safely as possible.

Project lead: Dr. Erika Howe

Stage of study: Analysis — Data has been sent to a facility in Amhearst for analysis.

The purpose of this study is to understand various quality of life factors, particularly differing emotional manifestations, in patients with Parkinson's Disease, utilizing an online format. Using a one-time web-based questionnaire, we aim to collect information relating to anxiousness, balance, movement, sleep, and aspects of movement related attention. These outcomes can assist in creating a comprehensive understanding of quality of life outcomes faced with PD patients. The findings of this work will guide researchers in creating more holistic treatments for PD patients.

This study involves a one-time online survey regarding various aspects of behaviour that may be impacted in day-to-day life. This survey may take approximately 1 hour to complete. Further information can be found in the survey link, including our information letter and consent.

Project lead: Salma Elasfar

Stage of study: Data collection

Freezing of gait is a complex and debilitating symptom of Parkinson’s disease where the feet feel "glued" to the floor. Recent research suggests that the body’s "fight or flight" system (part of the autonomic nervous system) plays a major role in freezing, particularly when a person feels anxious. However, it remains unclear if specific heart rhythm patterns (known as Heart Rate Variability) can predict whether someone is more susceptible to freeze, or if these patterns are simply a reaction to stress.

This study aims to disentangle the relationship between heart function, anxiety, and medication to see if resting heart rhythms can serve as a reliable marker for freezing vulnerability in a single visit that will take ~6 hours to complete in lab. Sufficient breaks will be included.

You will be asked to perform the experimental tasks twice during this visit: first in your 'OFF' medication state (after >12 hours without dopaminergic medication). Then again after taking your regular Parkinson’s medication, or ‘ON’ state. During each state, you will sit and stand quietly while we record your heart activity. You will then complete two types of movement assessments: a standard clinical walking test involving turning, dual-tasking and walking through doorways, and a Virtual Reality (VR) task where you will walk across a virtual plank at different heights. Before and throughout the session, you will also complete questionnaires regarding your Parkinson’s symptoms, anxiety levels, and general health.

Project lead: Arthur Eduardo Casagrande Pinto

Stage of study: Data collection — Accepting participants!