Treadmill Training In Patients Research Articles

Comparison of anti-gravity treadmill training and traditional treadmill training in patients with moderate to severe knee osteoarthritis: A randomized controlled trial.

Aerobic exercise is recommended to alleviate pain and protect the joint for patients with advanced knee osteoarthritis, however, its clinical implementation is challenging due to the potential for exacerbating pain. The study aimed to compare the effects of anti-gravity treadmill training with traditional treadmill training in patients with advanced knee osteoarthritis. This single-blinded randomized-controlled trial included 30 women with knee osteoarthritis. All participants received hotpack, transcutaneous electrical nerve stimulation, and therapeutic ultrasound. Additionally, group 1 received anti-gravity treadmill, while group 2 received traditional treadmill training. Group 3 served as the control. The interventions were administered three-times a week for eight-weeks. The visual analogue scale (VAS) pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), six-minute-walk-test distance (6MWD), and femoral cartilage thickness were evaluated at baseline and weeks 4 and 8. VAS-pain significantly reduced over time in both anti-gravity (P < 0.001) and control (P = 0.004) groups. The anti-gravity group also showed significant improvements in WOMAC-pain (P = 0.008), WOMAC-total (P = 0.048), and 6MWD (P < 0.001). Post-hoc analysis indicated significant time (P < 0.001, effect size, ηp2 = 0.682) and interaction (P = 0.006, ηp2 = 0.271) effects on VAS, with no significant between-group differences. Femoral cartilage thickness showed no significant between-group differences, except within-group differences in the treadmill group (P = 0.037). Anti-gravity treadmill training significantly improved pain, functionality, and functional capacity in patients with knee osteoarthritis, while traditional treadmill resulted in a reduction in femoral cartilage thickness. Further research should investigate long-term outcomes and more diverse populations. NCT05319964.

Comparing the effects of augmented virtual reality treadmill training versus conventional treadmill training in patients with stage II-III Parkinson's disease: the VIRTREAD-PD randomized controlled trial protocol.

Intensive treadmill training (TT) has been documented to improve gait parameters and functional independence in Parkinson's Disease (PD), but the optimal intervention protocol and the criteria for tailoring the intervention to patients' performances are lacking. TT may be integrated with augmented virtual reality (AVR), however, evidence of the effectiveness of this combined treatment is still limited. Moreover, prognostic biomarkers of rehabilitation, potentially useful to customize the treatment, are currently missing. The primary aim of this study is to compare the effects on gait performances of TT + AVR versus TT alone in II-III stage PD patients with gait disturbance. Secondary aims are to assess the effects on balance, gait parameters and other motor and non-motor symptoms, and patient's satisfaction and adherence to the treatment. As an exploratory aim, the study attempts to identify biomarkers of neuroplasticity detecting changes in Neurofilament Light Chain concentration T0-T1 and to identify prognostic biomarkers associated to blood-derived Extracellular Vesicles. Single-center, randomized controlled single-blind trial comparing TT + AVR vs. TT in II-III stage PD patients with gait disturbances. Assessment will be performed at baseline (T0), end of training (T1), 3 (T2) and 6 months (T3, phone interview) from T1. The primary outcome is difference in gait performance assessed with the Tinetti Performance-Oriented Mobility Assessment gait scale at T1. Secondary outcomes are differences in gait performance at T2, in balance and spatial-temporal gait parameters at T1 and T2, patients' satisfaction and adherence. Changes in falls, functional mobility, functional autonomy, cognition, mood, and quality of life will be also assessed at different timepoints. The G*Power software was used to estimate a sample size of 20 subjects per group (power 0.95, α < 0.05), raised to 24 per group to compensate for potential drop-outs. Both interventions will be customized and progressive, based on the participant's performance, according to a predefined protocol. This study will provide data on the possible superiority of AVR-associated TT over conventional TT in improving gait and other motor and non-motor symptoms in persons with PD and gait disturbances. Results of the exploratory analysis could add information in the field of biomarker research in PD rehabilitation.

Virtual reality augments effectiveness of treadmill walking training in patients with walking and balance impairments: A systematic review and meta-analysis of randomized controlled trials

Objective To systematically summarize and examine current evidence regarding the combination of virtual reality and treadmill training in patients with walking and balance impairments. Data sources English language randomized controlled trials, participants with walking and balance impairments, intervention group used virtual reality and treadmill, control group only used treadmill with the same training frequency and number of sessions. Six bioscience and engineering databases were searched. Methods Two independent reviewers conducted study selection, data extraction, and quality assessment. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Results Sixteen randomized controlled trials including 829 participants were identified. Compared to treadmill-only training, virtual reality augmented treadmill training induced significantly faster walking (p < 0.001; standardized mean difference (SMD) = 0.55, 95%CI: 0.30 to 0.81), longer step length (p < 0.001; SMD = 0.74, 95%CI: 0.42 to 1.06), narrower step width (p = 0.03; SMD = −0.52, 95%CI: −0.97 to −0.06), longer single leg stance period (p = 0.003; SMD = 0.77, 95%CI: 0.27 to 1.27), better functional mobility (p = 0.003; SMD = −0.44, 95%CI: − 0.74 to −0.15), improved balance function (p = 0.04; SMD = 0.24, 95%CI: 0.01 to 0.47), and enhanced balance confidence (p = 0.03; SMD = 0.73, 95%CI: 0.08 to 1.37). Walking endurance did not differ significantly between groups (p = 0.21; SMD = 0.13, 95%CI: −0.07 to 0.34). Conclusions Virtual reality augmented treadmill walking training enhances outcomes compared to treadmill-only training in patients with walking and balance impairments. The results of this review support the clinical significance of combining virtual reality with treadmill training with level 1A empirical evidence.

Exergaming and Treadmill Training in Stroke Patients

Treadmill training is nowadays considered more efficient in improving balance and mobility rather than simply walking on an even surface. In patients with chronic stroke, changes in cortico-motor excitability are induced to improve balance and gait performance. There is simple treadmill training that can enhance and motivate patients to walk but treadmill training with body support is safer and more comfortable for patients. In one study the effect of treadmill therapy with the optic flow on balance control and gait training helps the patients of stroke in regaining functional independence in the community. Outcome measures were used that were Time Up and Go test, Functional Reach Test (FRT), 10-minute walk test, and 6- minute walk test. It proved a better result for patients with chronic stroke [1]. Apart from gait training, treadmill training may be able to help in balance dysfunction in most individuals who have to complain of stroke [2]. It enhances the balance and mobility skills of chronic stroke patients. Treadmill training motivates the subject to give better physical performance after stroke. Exercise video games are an innovative idea not commonly used in Pakistan for stroke rehabilitation. Both these techniques are used to enhance motivation and self-confidence in walking and maintaining balance. It keeps the subject engaged in physical therapy sessions for a long time after stroke. Thus, video games and treadmill training are used in various clinical settings for stroke rehabilitation. A combination of both these techniques would help decrease balance and mobility impairments through effective use of Exergaming and Treadmill training in patients suffering from a stroke in the chronic phase. This study would help the therapists across the locality to enlist a better management approach to treat subjects with chronic stroke.

Method of Intermittent Normobaric Hypoxic Low-intensity Treadmill Training for Сardiac Rehabilitation of Patients after Coronary Artery Bypass Grafting

Aim. To develop a method of intermittent normobaric hypoxic low-intensity treadmill training for cardiac rehabilitation of patients inthe early postoperative stage after coronary artery bypass grafting. To assess the risks cardiovascular system (CVS) complications inusing the method. Material and methods. The study involved 44 patients (10 women aged 50 to 73 years and 34 men aged 40 to 71 years) with coronaryheart disease who underwent coronary artery bypass grafting. For cardiac rehabilitation, hypoxic gas mixtures were used, supplied tothe patient for breathing through an oxygen mask in combination with low-intensity training on the ReaTerra treadmill. To assess therisks of CVS complications when applying the method, we used the APKO-8-RIC oscillometric analyzer for cardiac output and bloodpressure parameters. The Robinson indices, endurance coefficient, Kerdo vegetative index, CVS adaptive potential index were calculated.Upon completion of the cardiac rehabilitation program, the subjects completed the SF – 36 Health Status Survey. Results. Studies have shown that the use of the cardiac rehabilitation method restored the level of blood pressure and heart rate,increased the Kerdo index of autonomic balance/ The Robinson index characterized the optimal work of the CVS, the endurance coefficientcharacterized the CVS endurance as satisfactory. The adaptive potential of the CVS corresponded to the physiological values ofthe norm, the activity of the heart was assessed as economical and effective, which testified to the satisfactory adaptation of patientsto the training process with the applied method. According to the questionnaire, physical and psychological components of health inpatients after a training course were qualitatively higher than before training. Conclusion. The method of intermittent normobaric hypoxytherapy in combination with low-intensity treadmill training in patients atthe early postoperative stage after coronary bypass grafting has shown high effectiveness in CVS diseases, contributing to the activationof adaptive, hemodynamic sanogenetic mechanisms, providing stimulation of rehabilitation potential in individuals of differentage groups and does not increase the risk of CVS complications.

The Effects of Balance and Gait on the Treadmill Training in Patients with Hemiplegia Applying Kinesio-Taping and Lumbosacral Orthosis

Objective: This study was conducted to investigate the effect of balance and gait on the treadmill training in patients with hemiplegia applying kinesio-taping and lumbosacral orthosis. Method: Thirty patients with hemiplegia were randomly selected and divided into three groups.: treadmill training group, treadmill training applying kinesio-taping group, and treadmill training applying lumbosacral orthosis group and they were 30 minute and 6 week trainings. Results from the study are described as follows. Results: Treadmill group shows significant difference in the length of 10 m gait test, gait speed, gait cadence, and stride(p<.05). Treadmill Applying kinesio-taping group shows significant difference in the length of 10 m gait test, gait speed, gait cadence, and length of stride(p<.05). Treadmill applying lumbosacral orthosis group shows significant difference in BBS, TUG, 10 m gait test, gait speed, gait cadence, stride, and stance phase and swing phase of the affected side(p<.05). In the comparison with interventions, there was a significant difference in BBS, TUG, 10 m gait test, gait speed, gait and stance phase and swing phase of the affected side(p<.05). Conclusion: These findings demonstrate that there was a difference in the effect of kinesio-taping and lumbosacral orthosis on trunk stability of patients with hemiplegia during treadmill training and application of lumbosacral orthosis leads to a more effective result in balance and gait changes during treadmill training for patients with hemiplegia.

Analysis of the association between selected factors and outcomes of treadmill gait training with biofeedback in patients with chronic stroke

To examine the effects of age, time from stroke onset, gender and side of paresis in gait re-education with the use of treadmill with biofeedback, in patients with chronic stroke. The study was performed with a group of 50 patients. 10-metre walk test, 2-minute walk test, "Up and Go" test, the number of steps performed with the paretic lower limb at a distance of 10 metres, Barthel index and FIM scale were used to assess the effects of rehabilitation. The study shows that the subjects' abilities and fitness prior to the rehabilitation were not related to age, sex or side of paresis. Analysis of the impact of age, time from stroke and sex on rehabilitation outcomes showed no statistically significant correlations. On the other hand, analysis of rehabilitation results relative to the side of paresis showed that the latter factor significantly differentiates rehabilitation outcomes measured with gait velocity test - p= 0.045. Age, duration of time from stroke onset, and sex do not affect outcomes of gait re-education based on treadmill training in patients at a chronic stage post-stroke and Brunnstrom recovery stage 3-4. Side of paresis significantly differentiates rehabilitation outcomes measured with speed test. The best scores in all the performance measures before rehabilitation were identified in the group 3-6 years after stroke.

Augmented Reality Treadmill Training in Patients With Parkinson's Disease

Augmented Reality Treadmill Training in Patients With Parkinson's Disease

Treadmill training in patients affected by Charcot-Marie-Tooth neuropathy: results of a multicenter, prospective, randomized, single-blind, controlled study.

Background and purposeMuscle‐strengthening, stretching or proprioceptive treatments may slow symptom progression in Charcot—Marie–Tooth (CMT) neuropathy. The aim of the study was to evaluate safety and efficacy of treadmill training in CMT1A.MethodsWe planned a multicenter, prospective, randomized, single‐blind, controlled study. We recruited 53 outpatients affected by CMT1A and randomized them into two treatment groups: one underwent stretching and proprioceptive exercise, whereas the other was additionally treated with treadmill training (TreSPE). Primary outcome measures (OMs) were the walking evaluations and secondary OM was the balance assessment. All participants were assessed at baseline and after 3 and 6 months of treatment.ResultsMost patients showed an improvement in at least one OM after 3 months [42/47 (89.4%)] and 6 months [38/40 (95%)] of treatment. No adverse events were reported in either group.ConclusionsThe most important finding was that both stretching and proprioceptive exercise and treadmill training had an objective benefit on patients affected by CMT disease, without causing overwork weakness. We had a low rate of drop out and did not find deterioration in motor performance. Our results also confirm that applying evidence‐based medicine methods to rehabilitative research is the correct way to test the efficacy of a treatment.

Mirror therapy and treadmill training for patients with chronic stroke: a pilot randomized controlled trial

ABSTRACTBackground: Previous lower-limb mirror therapy research has focused on non-weight bearing interventions.Objectives: The primary aim of this study was to investigate the effect and feasibility of a combination of mirror therapy and treadmill training on post-stroke lower-limb recovery compared to a placebo intervention.Methods: All patients (N = 30) walked on a treadmill for 30 min per day, 3 days per week, for 4 weeks. The mirror therapy and treadmill training group (n = 15) walked on the treadmill while viewing a reflection of their non-paretic limb in a mirror positioned in their mid-sagittal plane. The placebo group (n = 15) received no mirror visual feedback due to an altered mirror position. Primary outcome measures: Ten Metre Walk Test (10MWT) and Six Minute Walk Test (6MWT). Secondary outcome measures: Modified Ashworth Scale (MAS) and Fugl-Meyer Assessment-Lower Extremity (FMA-LE). Feasibility was appraised by examining participant compliance and any adverse events.Results: No significant between group differences were demonstrated for the 10MWT, 6MWT or FMA-LE at post-training or 3-month follow-up assessment. A significant between group difference on the MAS was demonstrated in the reduction of ankle dorsiflexion muscle tone (p = 0.006) and ankle plantarflexion muscle tone (p = 0.01) in the mirror therapy group compared to the placebo group at post-training assessment but not at 3-month follow-up.Conclusion: Our study reveals that in our group of patients with chronic stroke, mirror therapy combined with treadmill training facilitated significant reductions in ankle muscle tone (p < 0.05) compared to a placebo intervention.

Changes in claudication walking time measured on treadmill and in community setting outdoor walking after A 12-week supervised treadmill training in patients with claudication

Changes in claudication walking time measured on treadmill and in community setting outdoor walking after A 12-week supervised treadmill training in patients with claudication

Immediate Effects of Body-weight-supported Treadmill Training in Patients with Chronic Hemiparesis after Stroke in the Recovery Stage

Immediate Effects of Body-weight-supported Treadmill Training in Patients with Chronic Hemiparesis after Stroke in the Recovery Stage

Aerobic anti-gravity exercise in patients with Charcot-Marie-Tooth disease types 1A and X: A pilot study.

BackgroundCharcot–Marie–Tooth (CMT) disease is a hereditary neuropathy associated with impaired walking capacity. Some patients are too weak in the lower extremity muscles to walk at gravity with sufficient intensity or duration to gain benefit.AimThe aim was to investigate the effect of aerobic anti‐gravity exercise in weak patients with CMT 1A and X.MethodsFive adult patients performed moderate‐intensity aerobic anti‐gravity exercise 3/week for 10 weeks.ResultsThere was a significant positive difference in Berg balance scale and postural stability test between test occasions, and walking distance in the 6‐min walk test trended to increase.ConclusionsThe study indicates that the anti‐gravity treadmill training of patients with CMT should be pursued in larger CMT cohorts.

Treadmill in Parkinson’s: influence on gait, balance, BDNF and Reduced Glutathione

Abstract Introduction: Parkinson’s disease (PD) is characterized by nigrostriatal degeneration, with dopaminergic depletion, and inflammatory and oxidative changes in the brain, leading to movement and coordination disorders. Recent studies have shown that treadmill training can be beneficial for these patients, but there is little evidence assessing the related blood parameters, such as oxidative stress and neurotrophin levels. Objective: Assess the influence of treadmill training for patients with Parkinson’s on gait, balance, Brain-Derived Neurotrophic Factor (BDNF) and reduced glutathione. Methods: Twenty-two patients with PD (Hoehn and Yahr II and III), older than 40 years, were randomly allocated to two groups: CG (n = 12) - drug treatment and IG (n = 10) - treadmill. Assessments related to functional capacity (quality of life, static and dynamic analysis of gait) and blood parameters such as GSH and BDNF were conducted before and after the eight-week intervention. Results: The demographic data of the groups were homogeneous in terms of age, sex, height, weight, time since disease onset, mini mental examination and the geriatric depression scale. Significant intergroup differences were found for the mental component summary, surface variation, latero-lateral oscillation, antero-posterior oscillation and mean velocity in the post-intervention period. The IG exhibited a strong association between BDNF and GSH, with statistically significant values. Conclusion: It was concluded that controlled treadmill walking improves static balance, quality of life and plasma BDNF and GSH levels in patients with PD.

Intensive treadmill training in the acute phase after ischemic stroke.

The aim of the study was to (a) assess the feasibility of intensive treadmill training in patients with acute ischemic stroke, (b) test whether physical activity of the legs during training increases with time, and (c) evaluate to what extent training sessions contribute toward the overall physical activity of these patients. Twenty hospitalized patients with acute ischemic stroke trained on a treadmill twice daily for 30 min for 5 days and on day 30. Physical activity was measured as activity counts (AC) from accelerometers. A total of 196 of 224 initiated training sessions were completed. Training started 41.5±14 h after symptom onset. Only nonserious adverse events occurred in 14.7% of the sessions. An intensity of at least 50% of the individual heart rate reserve was obtained in 31% of training sessions. There was a significant increase in AC/min in the legs during training sessions with increasing number of days, with the median AC being 133% higher on day 5 than on day 1. AC in the paretic leg during 60 min of training constituted median 53% of the daytime AC. Early intensive treadmill training in acute ischemic stroke patients is thus feasible and contributes considerably toward the patients' overall physical activity.

Robot-assisted gait training versus treadmill training in patients with Parkinson's disease: a kinematic evaluation with gait profile score.

The purpose of this study was to quantitatively compare the effects, on walking performance, of end-effector robotic rehabilitation locomotor training versus intensive training with a treadmill in Parkinson's disease (PD). Fifty patients with PD were randomly divided into two groups: 25 were assigned to the robot-assisted therapy group (RG) and 25 to the intensive treadmill therapy group (IG). They were evaluated with clinical examination and 3D quantitative gait analysis [gait profile score (GPS) and its constituent gait variable scores (GVSs) were calculated from gait analysis data] at the beginning (T0) and at the end (T1) of the treatment. In the RG no differences were found in the GPS, but there were significant improvements in some GVSs (Pelvic Obl and Hip Ab-Add). The IG showed no statistically significant changes in either GPS or GVSs. The end-effector robotic rehabilitation locomotor training improved gait kinematics and seems to be effective for rehabilitation in patients with mild PD.

Treadmill training for patients with Parkinson's disease

Treadmill training is used in rehabilitation and is described as improving gait parameters of patients with Parkinson's disease. To assess the effectiveness of treadmill training in improving the gait of patients with Parkinson's disease and the acceptability and safety of this type of therapy. We searched the Cochrane Movement Disorders Group Specialised Register (see Review Group details for more information) (last searched September 2014), Cochrane Central Register of Controlled Trials (The Cochrane Library 2014, Issue 10), MEDLINE (1950 to September 2014), and EMBASE (1980 to September 2014). We also handsearched relevant conference proceedings, searched trials and research registers, and checked reference lists (last searched September 2014). We contacted trialists, experts and researchers in the field and manufacturers of commercial devices. We included randomised controlled trials comparing treadmill training with no treadmill training in patients with Parkinson's disease. Two review authors independently selected trials for inclusion, assessed trial quality and extracted data. We contacted the trialists for additional information. We analysed the results as mean differences (MDs) for continuous variables and relative risk differences (RD) for dichotomous variables. We included 18 trials (633 participants) in this update of this review. Treadmill training improved gait speed (MD = 0.09 m/s; 95% confidence interval (CI) 0.03 to 0.14; P = 0.001; I(2) = 24%; moderate quality of evidence), stride length (MD = 0.05 metres; 95% CI 0.01 to 0.09; P = 0.01; I(2) = 0%; low quality of evidence), but walking distance (MD = 48.9 metres; 95% CI -1.32 to 99.14; P = 0.06; I(2) = 91%; very low quality of evidence) and cadence did not improve (MD = 2.16 steps/minute; 95% CI -0.13 to 4.46; P = 0.07; I(2) = 28%; low quality of evidence) at the end of study. Treadmill training did not increase the risk of patients dropping out from intervention (RD = -0.02; 95% CI -0.06 to 0.02; P = 0.32; I(2) = 13%; moderate quality of evidence). Adverse events were not reported in included studies. This update of our systematic review provides evidence from eighteen trials with moderate to low risk of bias that the use of treadmill training in patients with PD may improve clinically relevant gait parameters such as gait speed and stride length (moderate and low quality of evidence, respectively). This apparent benefit for patients is, however, not supported by all secondary variables (e.g. cadence and walking distance). Comparing physiotherapy and treadmill training against other alternatives in the treatment of gait hypokinesia such as physiotherapy without treadmill training this type of therapy seems to be more beneficial in practice without increased risk. The gain seems small to moderate clinically relevant. However, the results must be interpreted with caution because it is not known how long these improvements may last and some studies used no intervention in the control group and underlie some risk of bias. Additionally the results were heterogenous and we found variations between the trials in patient characteristics, the duration and amount of training, and types of treadmill training applied.

Treadmill training for patients with Parkinson's disease.

Treadmill training is used in rehabilitation and is described as improving gait parameters of patients with Parkinson's disease. To assess the effectiveness of treadmill training in improving the gait of patients with Parkinson's disease and the acceptability and safety of this type of therapy. We searched the Cochrane Movement Disorders Group Specialised Register (see Review Group details for more information) (last searched September 2014), Cochrane Central Register of Controlled Trials (The Cochrane Library 2014, Issue 10), MEDLINE (1950 to September 2014), and EMBASE (1980 to September 2014). We also handsearched relevant conference proceedings, searched trials and research registers, and checked reference lists (last searched September 2014). We contacted trialists, experts and researchers in the field and manufacturers of commercial devices. We included randomised controlled trials comparing treadmill training with no treadmill training in patients with Parkinson's disease. Two review authors independently selected trials for inclusion, assessed trial quality and extracted data. We contacted the trialists for additional information. We analysed the results as mean differences (MDs) for continuous variables and relative risk differences (RD) for dichotomous variables. We included 18 trials (6 3 3 participants) in this update of this review. Treadmill training improved gait speed (MD = 0.09 m/s; 95% confidence interval (CI) 0.03 to 0.14; P = 0.001; I(2) = 24%; m oderate quality of evidence), stride length (MD = 0.05 metres; 95% CI 0.01 to 0.09; P = 0.01; I(2) = 0%; l ow quality of e vidence), but walking distance (MD = 48.9 metres; 95% CI -1.32 to 99.14; P = 0.06; I(2) = 91%; very low quality of evidence) and cadence did not improve (MD = 2.16 steps/minute; 95% CI -0.13 to 4.46; P = 0.07; I(2) = 28%; low quality of evidence) at the end of study. Treadmill training did not increase the risk of patients dropping out from intervention (RD = -0.02; 95% CI -0.06 to 0.02; P = 0.32; I(2) = 1 3%; m oderate quality of evidence). Adverse events were not reported in included studies. This update of our systematic review provides evidence from e ighteen trials with moderate to l ow risk of bias that the use of treadmill training in patients with PD may improve clinically relevant gait parameters such as gait speed and stride length (m oderate and low quality of evidence, respectively) . This apparent benefit for patients is, however, not supported by all secondary variables (e.g. cadence and walking distance ). Comparing physiotherapy and treadmill training against other alternatives in the treatment of gait hypokinesia such as physiotherapy without treadmill training this type of therapy seems to be more beneficial in practice without increased risk. The gain seems small to moderate clinically relevant . However, the results must be interpreted with caution because it is not known how long these improvements may last and some s tudies used no intervention in the control group and underlie some risk of bias . Additionally the results were heterogenous and we found variations between the trials in patient characteristics, the duration and amount of training, and types of treadmill training applied.

Visual cues combined with treadmill training to improve gait performance in Parkinson’s disease: a pilot randomized controlled trial

Objective: To evaluate the effects of visual cues combined with treadmill training on gait performance in patients with Parkinson’s disease and to compare the strategy with pure treadmill training. Design: Pilot, exploratory, non-blinded, randomized controlled trial. Setting: University Hospital of Munich, Germany. Subjects: Twenty-three outpatients with Parkinson’s disease (Hoehn and Yahr stage II–IV). Interventions: Patients received 12 training sessions within five weeks of either visual cues combined with treadmill training (n = 12) or pure treadmill training (n = 11). Main measures: Outcome measures were gait speed, stride length and cadence recorded on the treadmill. Functional tests included the Timed Up and Go Test, the Unified Parkinson’s Disease Rating Scale and the Freezing of gait-questionnaire. Assessments were conducted at baseline, after the training period and at two months follow-up. Results: After the training period (n = 20), gait speed and stride length had increased in both groups (p ⩽ 0.05). Patients receiving the combined training scored better in the Timed Up and Go Test compared with the patients receiving pure treadmill training (p ⩽ 0.05). At two months follow-up (n = 13), patients who underwent the combined training sustained better results in gait speed and stride length (p ⩽ 0.05) and sustained the improvement in the Timed Up and Go Test (p ⩽ 0.05). Conclusions: This pilot study suggests that visual cues combined with treadmill training have more beneficial effects on gait than pure treadmill training in patients with a moderate stage of Parkinson’s disease. A large-scale study with longer follow-up is required.

Partial Body Weight-Supported Treadmill Training in Patients With Parkinson Disease: Impact on Gait and Clinical Manifestation

ObjectiveTo evaluate the effect of conventional gait training (CGT) and partial weight-supported treadmill training (PWSTT) on gait and clinical manifestation. DesignProspective experimental research design. SettingHospital. ParticipantsPatients with idiopathic Parkinson disease (PD) (N=60; mean age, 58.15±8.7y) on stable dosage of dopaminomimetic drugs were randomly assigned into the 3 following groups (20 patients in each group): (1) nonexercising PD group, (2) CGT group, and (3) PWSTT group. InterventionsThe interventions included in the study were CGT and PWSTT. The sessions of the CGT and PWSTT groups were given in patient's self-reported best on status after regular medications. The interventions were given for 30min/d, 4d/wk, for 4 weeks (16 sessions). Main Outcome MeasuresClinical severity was measured by the Unified Parkinson Disease Rating Scale (UPDRS) and its subscores. Gait was measured by 2 minutes of treadmill walking and the 10-m walk test. Outcome measures were evaluated in their best on status at baseline and after the second and fourth weeks. ResultsFour weeks of CGT and PWSTT gait training showed significant improvements of UPDRS scores, its subscores, and gait performance measures. Moreover, the effects of PWSTT were significantly better than CGT on most measures. ConclusionsPWSTT is a promising intervention tool to improve the clinical and gait outcome measures in patients with PD.