title: [Potential analysis for research on physiotherapy-led treadmill training in Parkinson's disease].
abstract: OBJECTIVE
  Parkinson's disease is one of the major neurodegenerative disorders with prevalence rates between 0.1 and 0.2 % in the global population and 1.8 % in people aged 64 years and over. Future incidence rates are estimated to increase within aging societies. The progressive course of Parkinson's disease is clinically characterised by bradykinesia, rigidity and tremor. These limitations in motor functioning reduce the capacity to work, social participation and the clients' quality of life. Parkinson's disease causes incapacity to work and a large number of days off from work. The benefits clients expect from physiotherapy-led treatment include an improvement of gait, a better speed of motion and the decrease of fatigue and rigidity.
  A recent Cochrane review (Mehrholz et al., 2010) analysed seven randomised comparisons with 153 participants and found that treadmill training compared with no treatment improved gait speed (SMD 0.50; 95 % confidence interval [0.17 to 0.84]). A lack of evidence exists on how to reduce fatigue and rigidity. There is also need to evaluate long-term effects and cost-effectiveness. Furthermore, an updated meta-analysis should include eleven new randomised trials on treadmill training after 2009. Physiotherapy-led treadmill training can easily be transferred into the German healthcare context since the environmental and educational preconditions are met by German physiotherapeutic care.
  
  
  CONCLUSIONS
  Within the German context, there is need to prepare a randomised clinical trial evaluating the impact of physiotherapy-led treadmill training on motor functioning, quality of life, costs, adverse events und long-term effects. Prior to this, a feasibility study should explore the acceptance and intensity of treadmill training as well as the access of private physiotherapy practices to people suffering from early- to mid-stage Parkinson's disease.
authors.affiliation: Fakultät für Therapiewissenschaften, SRH Hochschule Heidelberg, Heidelberg, Deutschland. Electronic address: monika.lohkamp@hochschule-heidelberg.de.
authors.forename: Monika
authors.initials: M
authors.lastname: Lohkamp
authors.affiliation: hochschule 21, Buxtehude, Deutschland.
authors.forename: Cordula
authors.initials: C
authors.lastname: Braun
authors.affiliation: Fakultät für Therapiewissenschaften, SRH Hochschule Heidelberg, Heidelberg, Deutschland.
authors.forename: Mieke
authors.initials: M
authors.lastname: Wasner
authors.affiliation: Deutsches Cochrane Zentrum, Universitätsklinikum Freiburg, Freiburg, Deutschland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Voigt-Radloff
mesh_terms: D004185:Disability Evaluation; D019317:Evidence-Based Medicine; D005080:Exercise Test; D005684:Gait; D005858:Germany; D006801:Humans; D010300:Parkinson Disease / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D057170:Translational Research, Biomedical; D016138:Walking
keywords: Laufbandtherapie; Morbus Parkinson; Parkinson's disease; Physiotherapie; Wissenstransfer; physical therapy; technology transfer; treadmill training