Abstract
Two different training strategies to improve turning performance in individuals with Parkinson’s disease (PD) were designed and investigated in this study. Subjects were randomly assigned to a specific exercise group, turning-based training group, or control group to receive training that emphasized balance and strengthening, turning-based treadmill training, and general exercise training, respectively. A total of 12 30-min training sessions followed by 10 min of turning training on a level surface were administered over 4 to 6 weeks. The results (n = 12 for each group) showed that both the specific exercise and turning-based training group experienced improved turning performance, the primary outcome, compared with the control group (specific exercise, 33% change, p = 0.016; turning-based training, 35% change, p = 0.021). For the secondary outcomes, the specific exercise group performed better than the control group on the Tinetti balance scale, limit of stability test and lower extremity extensor and abductor strength. The turning-based training groups performed better than the control group in sensory organization and ankle plantar flexor strength. In summary, specific exercise training and turning-based treadmill training were both effective in improving turning performance in participants with PD. However, the improvements in turning performance of these two groups resulted from improving different aspects of impairment in individuals with PD.
Highlights
To our knowledge, only two studies have reported on the effects of exercise training on turning performance in patients with Parkinson’s disease (PD)
Because balance and lower extremity resistance training may optimize functional gait performance[8], and because a task-specific turning training protocol resulted in positive effects on turning performance[11], we hypothesized that a balance and resistance training regimen and a turning-based treadmill training program could improve turning performance
Three subjects in the turning-based training group reported dizziness during the first session of treatment; it subsided within 5 minutes and did not affect their willingness to participate
Summary
Only two studies have reported on the effects of exercise training on turning performance in patients with PD. It has been reported that balance and lower extremity strengthening exercises can result in positive effects on gait performance[8] It is not known whether training strategies that emphasize balance control and lower extremity muscle strength improve turning performance. The conclusion of a Cochrane review identified beneficial effects of treadmill training on gait parameters, including gait velocity, stride, and step length, in patients with PD10 Based on this task-specific concept, we designed a rotational treadmill and demonstrated that turning-based treadmill training could improve turning performance in individuals with chronic stroke[11]. Because balance and lower extremity resistance training may optimize functional gait performance[8], and because a task-specific turning training protocol resulted in positive effects on turning performance[11], we hypothesized that a balance and resistance training regimen and a turning-based treadmill training program could improve turning performance
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