The effects of speed-dependent treadmill training and rhythmic auditory-cued overground walking on balance function, fall incidence, and quality of life in individuals with idiopathic Parkinson's disease: a randomized controlled trial.
OBJECTIVE
The purpose of this single-blinded, randomized controlled study was to examine and compare the immediate and retention effects of progressive speed-dependent treadmill training (SDTT) and rhythmic auditory-cued (RAC) training on balance function, fall incidence, and quality of life (QOL) in individuals with PD.


METHODS
Twenty participants (mean age 66.1 yrs) with idiopathic PD were randomized into either SDTT (n = 10) or RAC (n = 10) progressive, interval-based locomotor training for 6 weeks. Measures included the Berg Balance Scale (BBS), Rapid Step-Up Test (RST), Activities-specific Balance Confidence Scale, Parkinson's Disease Questionnaire-39 (PDQ), and the NeuroCom Sensory Organization Test (SOT), Motor Control Test, and Limits of Stability (LOS). Fall incidence was assessed prospectively post-training based on six monthly self-report fall calendars.


RESULTS
Significant gains in balance measures were observed post-training in BBS, RST and SOT for the RAC group and in RST, SOT and LOS for the SDTT group. Gains were retained at 3 months post-training in all measures for RAC group, but only the RST for the SDTT group. No clear trend in reduction in fall frequency was evident.


CONCLUSIONS
Externally-cued locomotor training paradigms with progressive speed challenges produced significant improvements in dynamic balance function in persons with PD, with stronger retention of gains in RAC group.
Grand Valley State University, Grand Rapids, MI, USA.
C C
CC
Harro
Grand Valley State University, Grand Rapids, MI, USA.
M J
MJ
Shoemaker
Grand Valley State University, Grand Rapids, MI, USA.
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O
Frey
Grand Valley State University, Grand Rapids, MI, USA.
A C
AC
Gamble
Grand Valley State University, Grand Rapids, MI, USA.
K B
KB
Harring
Grand Valley State University, Grand Rapids, MI, USA.
K L
KL
Karl
Grand Valley State University, Grand Rapids, MI, USA.
J D
JD
McDonald
Grand Valley State University, Grand Rapids, MI, USA.
C J
CJ
Murray
Grand Valley State University, Grand Rapids, MI, USA.
J M
JM
VanDyke
Grand Valley State University, Grand Rapids, MI, USA.
E M
EM
Tomassi
Grand Valley State University, Grand Rapids, MI, USA.
R J
RJ
VanHaitsma
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000534:rehabilitation*; D010507:Periodicity; D004856:Postural Balance / Q000502:physiology*; D011788:Quality of Life; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016138:Walking
Parkinson's disease; locomotor training; rehabilitation