Parkinson's disease (PD) is a neurodegenerative disorder that affects movement and is characterized by tremors, rigidity, and bradykinesia (slow motion). Gait deficits, or difficulties with walking, are common in people with PD and can significantly impact their daily lives.
Clinical TrialA trial conducted by researchers from multiple centers investigated the effects of treadmill training on gait adaptation in people with PD. The study included 52 participants with PD, of whom 22 experienced freezing of gait, a common symptom in PD where the person feels as if their feet are glued to the ground and has difficulty initiating or maintaining walking. The participants were randomly assigned to either repeated split-belt treadmill (SBT) training or tied-belt treadmill (TBT) training, and the effects of the movement were assessed pre-and post-training, as well as at a 4-week follow-up.
FindingsThe trial results showed that SBT training, which involved adapting to different speeds of the treadmill belts, led to significant improvements in gait adaptation with moderate to large effect sizes compared to TBT training. These improvements were sustained at the follow-up assessment and were observed even during dual tasking, where participants performed a cognitive task while walking. However, the better gait adaptation skills learned on the treadmill did not transfer to over-ground turning speed, indicating that more research is needed to understand how to boost the transfer of complex walking skills in individuals with PD.
Interestingly, both SBT and TBT training resulted in improvements in over-ground walking and Movement Disorder Society-Unified Parkinson's Disease Rating Scale III (MDS-UPDRS-III) scores, which is a commonly used measure of motor function in PD. The improvements in MDS-UPDRS-III scores reached clinically meaningful effects in the SBT group only, suggesting that SBT training may have additional benefits in improving motor function in PD. Notably, the study did not find any impact on freezing of gait, indicating that further investigation is warranted in addressing this challenging symptom in PD.
ConclusionThe findings of this study suggest that treadmill training, particularly SBT training, might be a promising approach to improving gait adaptation skills in individuals with PD. The results highlight the potential of using treadmill training as a therapeutic intervention to address gait deficits in PD and improve motor function. However, more research is needed to understand better how to optimize the transfer of these skills to over-ground walking and turning, as well as to explore the long-term effects of treadmill training in individuals with PD. Future studies may also investigate the effects of treadmill training and other interventions to enhance different gait and motor functions in people with Parkinson's.
National Library of Medicine, Jan-23