| Frazzitta et al.(2323. Frazzitta G, Pezzoli G, Bertotti G, Maestri R. Asymmetry and freezing of gait in parkinsonian patients. J Neurol. 2013;260(1):71-6.)
|
30 patients with gait disturbance, but without FOG in “on” stage and 30 patients with FOG in “on” stage |
Patients underwent a 4-week rehabilitation treatment using a treadmill with auditory and visual cues |
Gait speed, stride length, asymmetry of gait, 6MWT, UPDRS II-III, Berg Balance Scale, TUG, comfortable-fast gait speeds, FOG-Q |
Data support a direct involvement of the asymmetry of gait in the development of FOG in PD
TT is effective in improving gait and balance in PD FOG patients, and this might be related to a reduction of asymmetric gait |
| Yang et al.(2424. Yang YR, Tseng CY, Chiou SY, Liao KK, Cheng SJ, Lai KL, et al. Combination of rTMS and treadmill training modulates corticomotor inhibition and improves walking in Parkinson disease: a randomized trial. Neurorehabil Neural Repair. 2013;27(1):79-86.)
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20 patients with PD with ability to walk independently |
-2 groups:
1. Participants received rTMS (Experimental Group)
2. Participants received sham rTMS (Control Group)
Followed by TT (30 minutes) for 12 sessions over 4 weeks (3 sessions a week) |
Corticomotor inhibition and walking performance |
The findings suggested that combination of rTMS and TT enhances the effect of TT on modulation of corticomotor inhibition and improvement of walking performance in those with PD |
| Galli et al.(2525. Galli M, Cimolin V, De Pandis MF, Le Pera D, Sova I, Albertini G, et al. Robot-assisted gait training versus treadmill training in patients with Parkinson's disease: a kinematic evaluation with gait profile score. Funct Neurol. 2016;31(3):163-70.)
|
50 idiopathic PD
Ability to walk, unassisted or with little assistance, for a distance of 25 feet |
-2 groups
1. Robot-assisted therapy group (n=25)
2. Intensive treadmill therapy group (n=25) |
Hoehn and Yahr scaleUPDRS
Optoelectronic system (ELITE2002, BTS, Milan, Italy) |
In the robot group, differences were found in kinematic variables (pelvic obliquity and hip abduction and adduction). The intensive group showed no statistically significant changes. The end-effector robotic rehabilitation locomotor training improved gait kinematics and seems to be effective for rehabilitation in patients with mild PD |
| Canning et al.(2626. Canning CG, Allen NE, Dean CM, Goh L, Fung VS. Home-based treadmill training for individuals with Parkinson's disease: a randomized controlled pilot trial. Clin Rehabil. 2012;26(9):817-26.)
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20 people with idiopathic PD with <2 hours per week of leisure time physical activity in prior 3 months, and had a stable response to levodopa medications |
-2 groups:
1. The Experimental Group undertook a semi-supervised home-based program of 30-40 minutes of treadmill walking, 4 times a week for 6 weeks
2. The Control Group received usual care (i.e. advice to maintain current levels of physical activity) |
The primary outcome measure of efficacy was walking capacity (6MWT) |
Semi-supervised home-based TT is a feasible and safe form of exercise for cognitively intact people, with mild PD |
| Frazzita et al.(2727. Frazzitta G, Maestri R, Uccellini D, Bertotti G, Abelli P. Rehabilitation treatment of gait in patients with Parkinson's disease with freezing: a comparison between two physical therapy protocols using visual and auditory cues with or without treadmill training. Mov Disord. 2009;24(8):1139-43.)
|
40 Parkinsonian patients with freezing were randomly assigned to two groups |
2 group:
1. Underwent a rehabilitation program based on treadmill training associated with auditory and visual cues
2. Followed a rehabilitation protocol using cues and not associated with treadmill |
Functional evaluation was based on the Unified Parkinson's Disease Rating Scale Motor Section (UPDRS III); Freezing of Gait Questionnaire (FOGQ), 6-minute walking test (6MWT), gait speed, and stride cycle |
The results suggest that treadmill training associated with auditory and visual cues might give better results than more conventional treatments.
Treadmill training probably acts as a supplementary external cue |
| Picelli et al.(2828. Picelli A, Melotti C, Origano F, Neri R, Waldner A, Smania N. Robot-assisted gait training versus equal intensity treadmill training in patients with mild to moderate Parkinson's disease: a randomized controlled trial. Parkinsonism Relat Disord. 2013;19(6):605-10.)
|
60 patients with mild to moderate PD |
3 groups:
1. Robotic gait training group (n=20);TT group (n=20) performed equal intensity
2. TT without body-weight support
3. The physical therapy group (n=20) underwent conventional gait therapy45 minutes per session 3 days/week, during four consecutive weeks |
10-minute walking test6MWT |
No statistically significant difference was found between the robotic gait training group and the TT group in the evaluation after training.
Statistically significant improvement was found after treatment in favor of the robotic gait training group and TT group compared to the physical therapy group. Findings were confirmed at the 3-month follow-up evaluation |
| Fisher et al.(2929. Fisher BE, Wu AD, Salem GJ, Song J, Lin CH, Yip J, et al. The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson's disease. Arch Phys Med Rehabil. 2008;89(7):1221-9.)
|
30 PD patients, within 3 years of diagnosis, with Hoehn and Yahr stages 1 or 2 |
3 groups:
1. High-intensity (body weight-supported TT)
2. Low-intensity exercise (exercises to range of motion, balance and gait)
3. Zero-intensity (education group) |
UPDRS
Biomechanical analysis of self-selected and fast walking
Sit-to-stand tasks Corticomotor excitability |
A small improvement in total and motor UPDRS was observed in all groups.
High-intensity group subjects showed post-exercise increases in gait speed, step and stride length, and hip and ankle joint excursion during self-selected and fast gait, besides improved weight distribution during sit-to-stand tasks.
Improvements in gait and sit-to-stand measures were not consistently observed in the low- and zero-intensity groups. The high-intensity group showed lengthening in cortical silent period |
| Schlick et al.(3030. Schlick C, Ernst A, Bötzel K, Plate A, Pelykh O, Ilmberger J. Visual cues combined with treadmill training to improve gait performance in Parkinson's disease: a pilot randomized controlled trial. Clin Rehabil. 2016;30(5):463-71.)
|
23 outpatients with PD |
Patients received 12 training sessions within 5 weeks of either visual cues combined with TT (n=12) or pure TT (n=11) |
Gait speed, stride length and cadence
Functional tests included the TUG test, the UPDPRS and the freezing of gait-questionnaire |
This pilot study suggests that visual cues combined with TT have more beneficial effects on gait than pure TT, in patients with a moderate stage of PD. A large-scale study with longer follow-up is required |
| Arcolin et al.(3131. Arcolin I, Pisano F, Delconte C, Godi M, Schieppati M, Mezzani A, et al. Intensive cycle ergometer training improves gait speed and endurance in patients with Parkinson's disease: a comparison with treadmill training. Restor Neurol Neurosci. 2016;34(1):125-38.)
|
29 patients with the diagnosis of idiopathic PDAbility to walk, unassisted |
2 groups (randomized):
1. Treadmill (n=13)
2. Cycle ergometer (n=16) Training for 3 weeks, 1 hour/day |
6MWT
Spatiotemporal variables of gait assessed by baropodometry
TUG test
MINIBESTest
UPDRS |
This pilot study shows that cycle ergometer training improves walking parameters and reduces clinical signs of PD, as much as TT does. Gait velocity is accompanied by step lengthening, making the gait pattern close to that of healthy subjects. Cycle ergometer is a valid alternative to treadmill for improving gait in short-term in patients with PD |
| Herman et al.(3232. 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. Arch Phys Med Rehabil. 2007;88(9):1154-8.)
|
9 patients with PD who were able to ambulate independently and were not demented |
Patients walked on a treadmill for 30 minutes during each training session, 4 training sessions a week, for 6 weeks |
PDQ-39
UPDRS
Gait speed, stride time variability, swing time variability
SPPB |
These results show the potential to enhance gait rhythmicity in patients with PD and suggest that a progressive and intensive
TT program can be used to minimize impairments in gait, reduce fall risk, and increase quality of life of these patients |
| Fernández-Lago et al.(3333. Fernández-Lago H, Bello O, Mora-Cerdá F, Montero-Cámara J, Fernández-Del-Olmo MÁ. Treadmill walking combined with anodal transcranial direct current stimulation in Parkinson disease: a pilot study of kinematic and neurophysiological effects. Am J Phys Med Rehabil. 2017;96(11):801-8.)
|
18 idiopathic PD patientsAbility to walk, unassisted |
18 participants with PD were evaluated under the following three conditions (groups):
1. Treadmill walking alone (treadmill)
2. Treadmill walking combined with anodal tDCS (AtDCS + treadmill) delivered over the motor cortex
3. Treadmill walking combined with sham stimulation (StDCS+treadmill) |
Overground walking performance, soleus H-reflex, reciprocal Ia inhibition from the tibialis anterior to the soleus muscle, intracortical facilitation, and short intracortical inhibition of the tibialis anterior muscle |
All treadmill conditions improved walking performance and modulated spinal and corticospinal parameters compare with other kind of treatments. However, AtDCS + treadmill lead to a different modulation of reciprocal Ia inhibition in comparison with the other treadmill conditions |
