Abstract
ABSTRACTParkinson's disease is the second most common neurodegenerative disorder in old age. Aging process for elders with Parkinson's disease can induce gait disturbances with more functional disabilities than for elders without the disease. Treadmill training as a therapy has resulted in notable effects on the gait of patients with Parkinson's disease and may be a resource for geriatric neurological rehabilitation. This review aimed to study the effects on gait after treadmill training in elderly patients with Parkinson's disease. The search was performed in the databases PubMed®, LILACS, PEDro and EMBASE, with the following keywords: “Parkinson's disease”, “elderly”, “treadmill training” and “gait evaluation”. The quality of the studies included was assessed by PEDro Scale. Eleven studies met the inclusion and exclusion criteria. Eight studies were randomized, and only one did a follow-up. One can observe in this review that treadmill training with or without weight support (at least 20 minutes, two to three times a week, with progressive increase of loads, for minimum of 6 weeks) in elderly patients with the Parkinson's disease was effective to improve gait. In addition, both were considered safe (since some studies described the use of belts, even in unsupported training) and can be associated with therapies complementary to gait, such as repetitive transcranial magnetic stimulation, visual cues or anodal transcranial direct current stimulation. Treadmill training in elderly patients with Parkinson's disease is an intervention that improves gait outcomes, but further studies are required for better proofs.
Highlights
Idiopathic Parkinson’s disease (PD) is a chronic, progressive and degenerative disease of the central nervous system, associated with a depletion in dopaminergic neurons in the nigrostriatal pathway.[1]
Concerning physical gait rehabilitation, treadmill training (TT) as a therapy has shown notable effects on the gait of patients with PD, with superior results in gait parameters compared to patients not undergoing this treatment.[16,17,18,19,20,21] Literature reviews show that the TT can promote a more stable walking pattern in PD patients, and suggest that the intervention is able to restore rhythmicity and reduces gait variability.[18,21,22] they analyzed various outcomes, but with no emphasis on the elderly
❚❚METHODS Search strategy The search was performed in PubMed®, LILACS, PEDro and EMBASE database; and published articles related to the effects of TT on the gait of elderly patients with PD were found based on the following keywords: “Parkinson’s disease”, “elderly”, “treadmill training” and “gait evaluation”
Summary
Idiopathic Parkinson’s disease (PD) is a chronic, progressive and degenerative disease of the central nervous system, associated with a depletion in dopaminergic neurons in the nigrostriatal pathway.[1]. Cardinal symptoms include resting tremor, muscular rigidity, freezing of gait (FOG); bradykinesia and gait and postural instability.[3,4] Gait disorders compromise patients’ independence and quality of life, decreasing mobility and increasing the risk of falls and fractures.[5] Parkinson’s disease induces gait disturbances, such as reduced velocity, reduced stride and step length, and increased duration of double stance.[4,5,6,7,8]. ❚❚OBJETIVE The objective of this study was to review the effects on gait after treadmill training in elderly Parkinson’s disease patients
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