Six Weeks of Intensive Treadmill Training Improves Gait and Quality of Life in Patients With Parkinson’s Disease: A Pilot Study

Herman T, Giladi N, Gruendlinger L, Hausdorff JM. Six weeks of intensive treadmill training improves gait and quality of life in patients with Parkinson’s disease: a pilot study.ObjectiveTo 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).DesignAn open-label, before-after pilot study.SettingOutpatient movement disorders clinic.ParticipantsNine 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).InterventionsPatients 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 MeasuresThe 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).ResultsA 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 1.26m/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.ConclusionsThese 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.