Abstract
Background/aimBody weight-supported treadmill training (BWSTT) might have greater effects than conventional treadmill training (TT) in neurological diseases such as Parkinson's disease (PD). The aim of this study was to evaluate the effects of different percentages of BWSTT on gait, balance, quality of life, and fatigue in PD.Materials and methodsThirty-five patients with moderate to advanced PD were randomized into three BWSTT groups according to the supported percentage of body weight: 0% BWSTT (control group; unsupported TT), 10% BWSTT, or 20% BWSTT. Five patients were excluded due to early discharge and 30 patients completed BWSTT sessions lasting 30 min, 5 days a week, for 6 weeks during their inpatient rehabilitation stay. The primary outcome was 6-min walk distance (6MWD). Secondary outcomes were Unified Parkinson's Disease Rating Scale (UPDRS), Berg Balance Scale (BBS), Nottingham Health Profile (NHP), Fatigue Impact Scale, and Fatigue Severity Scale scores. Measurements were performed before and after the training. ResultsThe unsupported TT group demonstrated no significant improvement in the outcome measures after a 6-week training except for BBS and NHP emotional subscores. Moreover, the NHP pain subscore increased in the unsupported TT group after training. The 10% and 20% supported BWSTT groups demonstrated significant improvements in 6MWD (P = 0.004 and P < 0.001, respectively), UPDRS - motor score (P = 0.012 and P = 0.005, respectively), NHP pain subscore (P = 0.003 and P = 0.002, respectively), and fatigue (P = 0.005 for both) after training. The 20% BWSTT provided the highest improvement in balance among the three groups (P < 0.001) and greater relief of fatigue than 10% BWSTT (P = 0.002).ConclusionSix weeks of BWSTT improved walking distance and balance ability, relieved fatigue, and additionally reduced pain in patients with moderate to advanced PD.
Highlights
Parkinson’s disease (PD) is a progressive and degenerative disorder characterized by an inadequate production of dopamine due to pathology in the substantia nigra
The unsupported treadmill training (TT) group demonstrated no significant improvement in the outcome measures after a 6-week training except for Berg Balance Scale (BBS) and Nottingham Health Profile (NHP) emotional subscores
The 10% and 20% supported Body weight-supported treadmill training (BWSTT) groups demonstrated significant improvements in 6-min walk distance (6MWD) (P = 0.004 and P < 0.001, respectively), Unified Parkinson’s Disease Rating Scale (UPDRS) - motor score (P = 0.012 and P = 0.005, respectively), NHP pain subscore (P = 0.003 and P = 0.002, respectively), and fatigue (P = 0.005 for both) after training
Summary
Parkinson’s disease (PD) is a progressive and degenerative disorder characterized by an inadequate production of dopamine due to pathology in the substantia nigra. Gait and balance impairments are important determinants of disability and quality of life in PD [2]. Fatigue is one of the most common and disabling nonmotor symptoms and can be seen at all stages of the disease [3]. Aerobic training with treadmill training (TT) is effective in improving the gait, balance, and quality of life and relieving fatigue in subjects with PD [4,5]. Physical performance and aerobic activities can be performed at higher intensities when the body weight is partially supported during walking compared to conventional TT [7]. This is especially beneficial in the rehabilitation of neurologically
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