At the UNT Health Science Center in Fort Worth, researchers are doing something unusual: They’re making people fall down. It’s all happening at the Human Movement Performance Lab, where they’re mapping how people with Parkinson’s disease and other mobility issues react to jolts and falls.
Learning from a fall
Neva Fittz is 76 years old. She’s standing on a giant treadmill, getting clipped into a full-body harness. If she were to trip and fall, ropes that are secured to the walls and ceiling would catch and dangle her several feet above the ground. The image of Tom Cruise in “Mission Impossible” comes to mind.
“There’s that certain amount of fear there, but you just think, ‘OK, if I’m going to fall, I have to catch myself,’” Fittz said.
Fittz is also wearing head-to-toe black spandex with 54 nickel-sized balls taped all across her body – from the top of her head all the way down to her ankles.
“This is the same technology they use in some of the movies these days. Avatar uses it. Back in the day, Shrek used it,” said Dr. Evan Papa, an assistant professor at the Health Science Center, a physical therapist and a principal investigator at UNT’s Human Movement Performance Lab.
“Those markers allow us to recreate the individual in a three-dimensional picture on the computer. And then, in our laboratory, 12 cameras that go in a full 360-degree motion around the individual pick up those reflective balls, and they allow us to look at very minute detail,” he said.
Those details include the range of motion in joints: the knee, the wrist, the hip – and what happens to each of them when someone takes a step or falls.
Fittz begins walking on the giant treadmill. Things are going smoothly, and then a jolt in the machine causes her to stumble.
Here's what the @UNTHSC @HMPLab is up to: mapping falls to better care for people with Parkinson's. This #Breakthroughs airs Wednesday! pic.twitter.com/AxA9cftLmN
— Stephanie Kuo (@stephanieskuo) June 19, 2017
“We can induce what’s like a slipping type of scenario, or we can induce a tripping type of scenario,” Papa said. “And then, we’ll analyze how someone with Parkinson’s disease recovers from a step and how that compares to someone who's neurologically healthy.”
Coping with instability
Parkinson’s is just one of several conditions the movement lab investigates. Researchers use the same gear to look at people with diabetes and autism. For children and teens on the autism spectrum, they’re using virtual reality to study how those subjects coordinate their sight and motor abilities.
They’re also using data from the lab to convince insurance companies to cover costs for better prosthetics and technology for amputees.
Papa’s expertise, though, is Parkinson’s. And on this day, Neva Fittz is his neurologically healthy “control.” He’ll compare her data to someone with Parkinson’s – like Fittz’s husband, Jim.
“He denied it in the beginning, but it’s generational. His grandfather had it, his dad had it,” Fittz said.
He was diagnosed six years ago. Parkinson’s is a progressive disease, which means his condition will only get worse.
“We can tell with the tremors and the jerking,” she said. “But, he has started to exercise. It’s been beneficial for his balance because he trips easily.”
In fact, a person with Parkinson’s is up to twice as likely to fall as someone who’s neurologically healthy – in part because people with Parkinson’s tend to have shorter strides.
“Someone with Parkinson’s inherently has a smaller margin of stability,” Papa said. “For instance, if you and I are walking through a crowded mall or about to step onto a bus, and we get bumped, we have the ability inherently to take a large enough step — so what we call our ‘margin of stability’ is large enough so we don’t fall outside of that and go over.”
Few cures with heavy costs
And treating a fall leads to “astronomical” costs, Papa said, especially for older folks. The CDC reports about 800,000 people go to the hospital each year after a fall – most often for a broken hip or head injury. The average hospital cost is more than $30,000. In 2015, costs for falls to Medicare alone totaled over $31 billion. These numbers are expected to rise as the U.S. population continues to age.
“So, we want to prevent falls. We want you do have the strength to be able to do what you want to do,” said Dr. Rita Patterson, director of the Human Movement Performance Lab. “Do you want to hold your grandchildren? Do you want to play golf? Do you want to be able to walk and shop in the mall and have the stamina to do that?”
Patterson knows what they do at the lab won’t cure Parkinson’s. There is no cure. But even small discoveries go directly to doctors and physical therapists, who can help improve lives.
“If we find out that cranial manipulation helps people with Parkinson’s, maybe you would benefit from having this exercise program, this treatment or doing whatever activity we find,” Patterson said. “Then maybe [doctors] start going to their conferences and say, ‘Hey, we’ve got some evidence that this is working with this patient population.’”
Patterson said analyzing human performance isn’t new and using motion capture isn’t either. But, no one in North Texas is studying Parkinson’s this way.
And that’s good news for Neva and Jim Fittz.
“This is just one more bump in the road, so we’ll do the best we can with it,” she said. “That’s kind of how we’ve taken it.”
Fittz said her husband’s learning more about his body every day. And thanks to some ropes, a full-body harness and a bit of Hollywood technology, so is she.
