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


METHODS
An open-label, before-after pilot study.


METHODS
Outpatient movement disorders clinic.


METHODS
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).


METHODS
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.


METHODS
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.
Herman
Talia
T
Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Department of Physical Therapy, Sackler School of Medicine, Tel-Aviv University, Israel.
Giladi
Nir
N
Gruendlinger
Leor
L
Hausdorff
Jeffrey M
JM
D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000503:physiopathology / Q000534:rehabilitation*; D010865:Pilot Projects; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome