title: Visual cues combined with treadmill training to improve gait performance in Parkinson's disease: a pilot randomized controlled trial.
abstract: 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.
  
  
  METHODS
  Pilot, exploratory, non-blinded, randomized controlled trial.
  
  
  METHODS
  University Hospital of Munich, Germany.
  
  
  METHODS
  Twenty-three outpatients with Parkinson's disease (Hoehn and Yahr stage II-IV).
  
  
  METHODS
  Patients received 12 training sessions within five weeks of either visual cues combined with treadmill training (n = 12) or pure treadmill training (n = 11).
  
  
  METHODS
  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.
authors.affiliation: Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), Munich, Germany German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany cornelia.schlick@med.uni-muenchen.de.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Schlick
authors.affiliation: Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), Munich, Germany.
authors.forename: Alina
authors.initials: A
authors.lastname: Ernst
authors.affiliation: Department of Neurology, University Hospital of Munich (LMU), Munich, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Bötzel
authors.affiliation: Department of Neurology, University Hospital of Munich (LMU), Munich, Germany.
authors.forename: Annika
authors.initials: A
authors.lastname: Plate
authors.affiliation: Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), Munich, Germany.
authors.forename: Olena
authors.initials: O
authors.lastname: Pelykh
authors.affiliation: Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), Munich, Germany.
authors.forename: Josef
authors.initials: J
authors.lastname: Ilmberger
mesh_terms: D000368:Aged; D003463:Cues; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D005858:Germany; D006801:Humans; D008297:Male; D010045:Outpatients; D010300:Parkinson Disease / Q000150:complications / Q000534:rehabilitation*; D010865:Pilot Projects; D014796:Visual Perception
keywords: Parkinson’s disease; cueing; gait; rehabilitation; treadmill training