Six weeks of intensive treadmill training improves gait and quality of life in patients with parkinson\u92s disease: A pilot study

Objective To evaluate the effects of 6 weeks of intensive treadmill training on gait rhythmicity, functional mobility, and quality of life (QOL) in patients with Parkinson\u92s disease (PD). Design An open-label, before-after pilot study. Setting Outpatient movement disorders clinic. Participants Nine patients with PD who were able to ambulate independently and were not demented. Mean age was 70\ub16.8 years. Patients had mild to moderate PD (Hoehn and Yahr stage range, 1.5-3). Interventions Patients 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 Measures The 39-item Parkinson\u92s Disease Questionnaire (PDQ-39), motor part of the Unified Parkinson\u92s Disease Rating Scale (UPDRS), gait speed, stride time variability, swing time variability, and the Short Physical Performance Battery (SPPB). Results A 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. Conclusions These 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 patient