Six weeks of intensive treadmill training improves gait and quality of life in patients with Parkinson's disease: a pilot study

Talia Herman, Nir Giladi, Leor Gruendlinger, Jeffrey M Hausdorff
Archives of Physical Medicine and Rehabilitation 2007, 88 (9): 1154-8

OBJECTIVE: To evaluate the effects of 6 weeks of intensive treadmill training on gait rhythmicity, functional mobility, and quality of life (QOL) in patients with Parkinson's disease (PD).

DESIGN: An open-label, before-after pilot study.

SETTING: Outpatient movement disorders clinic.

PARTICIPANTS: Nine patients with PD who were able to ambulate independently and were not demented. Mean age was 70+/-6.8 years. Patients had mild to moderate PD (Hoehn and Yahr stage range, 1.5-3).

INTERVENTIONS: Patients walked on a treadmill for 30 minutes during each training session, 4 training sessions a week, for 6 weeks. Once a week, usual overground walking speed was re-evaluated and the treadmill speed was adjusted accordingly.

MAIN OUTCOME MEASURES: The 39-item Parkinson's Disease Questionnaire (PDQ-39), motor part of the Unified Parkinson's Disease Rating Scale (UPDRS), gait speed, stride time variability, swing time variability, and the Short Physical Performance Battery (SPPB).

RESULTS: A comparison of the measures taken before and after the treadmill intervention indicates general improvement. QOL, as measured by the PDQ-39, was reduced (improved) from 32 to 22 (P<.014). Parkinsonian symptoms, as measured by the UPDRS, decreased (improved) from 29 to 22 (P<.043). Usual gait speed increased from 1.11 to 1.26 m/s (P<.014). Swing time variability was lower (better) in all but one patient, changing from 3.0% to 2.3% (P<.06). Scores on the SPPB also improved (P<.008). Interestingly, many of the improvements persisted even 4 weeks later.

CONCLUSIONS: These results show the potential to enhance gait rhythmicity in patients with PD and suggest that a progressive and intensive treadmill training program can be used to minimize impairments in gait, reduce fall risk, and increase QOL in these patients.

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