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Treadmill training for patients with Parkinson's disease.

Abstract

BACKGROUND

Treadmill training is used in rehabilitation and is described as improving gait parameters of patients with Parkinson's disease.

OBJECTIVES

To assess the effectiveness of treadmill training in improving the gait function of patients with Parkinson's disease and the acceptability and safety of this type of therapy.

SEARCH STRATEGY

We searched the Cochrane Movement Disorders Group Specialised Register (see Review Group details for more information) (last searched March 2009), Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 2), MEDLINE (1950 to March 2009), and EMBASE (1980 to March 2009).We also handsearched relevant conference proceedings, searched trials and research registers, and checked reference lists (last searched March 2009). We contacted trialists, experts and researchers in the field and manufacturers of commercial devices.

SELECTION CRITERIA

We included randomised controlled trials comparing treadmill training with no treadmill training in patients with Parkinson's disease.

DATA COLLECTION AND ANALYSIS

Two review authors independently selected trials for inclusion, assessed trial quality and extracted data. We contacted the trialists for additional information. We analysed the results as standardised mean differences (SMDs) and mean differences (MDs) for continuous variables and relative risk differences (RD) for dichotomous variables.

MAIN RESULTS

We included eight trials (203 participants) in this review. Treadmill training improved gait speed (SMD 0.50; 95% confidence interval (CI) 0.17 to 0.84; P = 0.003; I(2) = 0%) (fixed-effect model), stride length (SMD 0.42; 95% CI 0.00 to 0.84; P = 0.05; I(2) = 0%), walking distance (MD = 358 metres; 95% CI 289 to 426; P < 0.0001; I(2) = 30%), but cadence did not improve (MD 1.06; 95% CI -4.32 to 6.44; P = 0.70; I(2) = 0%) at the end of study. Treadmill training did not increase the risk of patients dropping out (RD -0.07; 95% CI -0.18 to 0.05; P = 0.26; I(2) = 51%) (random-effects model). Adverse events were not reported.

AUTHORS' CONCLUSIONS

Patients with Parkinson's disease who receive treadmill training are more likely to improve their impaired gait hypokinesia. However, the results must be interpreted with caution because there were variations between the trials in patient characteristics, the duration and amount of training, and types of treatment. Additionally, it is not known how long these improvements may last.

Authors+Show Affiliations

Wissenschaftliches Institut, Private Europäische Medizinische Akademie der Klinik Bavaria in Kreischa GmbH, An der Wolfsschlucht 1-2, Kreischa, Germany, 01731.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

20091652

Citation

Mehrholz, Jan, et al. "Treadmill Training for Patients With Parkinson's Disease." The Cochrane Database of Systematic Reviews, 2010, p. CD007830.
Mehrholz J, Friis R, Kugler J, et al. Treadmill training for patients with Parkinson's disease. Cochrane Database Syst Rev. 2010.
Mehrholz, J., Friis, R., Kugler, J., Twork, S., Storch, A., & Pohl, M. (2010). Treadmill training for patients with Parkinson's disease. The Cochrane Database of Systematic Reviews, (1), CD007830. https://doi.org/10.1002/14651858.CD007830.pub2
Mehrholz J, et al. Treadmill Training for Patients With Parkinson's Disease. Cochrane Database Syst Rev. 2010 Jan 20;(1)CD007830. PubMed PMID: 20091652.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treadmill training for patients with Parkinson's disease. AU - Mehrholz,Jan, AU - Friis,Robert, AU - Kugler,Joachim, AU - Twork,Sabine, AU - Storch,Alexander, AU - Pohl,Marcus, Y1 - 2010/01/20/ PY - 2010/1/22/entrez PY - 2010/1/22/pubmed PY - 2010/4/17/medline SP - CD007830 EP - CD007830 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 1 N2 - BACKGROUND: Treadmill training is used in rehabilitation and is described as improving gait parameters of patients with Parkinson's disease. OBJECTIVES: To assess the effectiveness of treadmill training in improving the gait function of patients with Parkinson's disease and the acceptability and safety of this type of therapy. SEARCH STRATEGY: We searched the Cochrane Movement Disorders Group Specialised Register (see Review Group details for more information) (last searched March 2009), Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 2), MEDLINE (1950 to March 2009), and EMBASE (1980 to March 2009).We also handsearched relevant conference proceedings, searched trials and research registers, and checked reference lists (last searched March 2009). We contacted trialists, experts and researchers in the field and manufacturers of commercial devices. SELECTION CRITERIA: We included randomised controlled trials comparing treadmill training with no treadmill training in patients with Parkinson's disease. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials for inclusion, assessed trial quality and extracted data. We contacted the trialists for additional information. We analysed the results as standardised mean differences (SMDs) and mean differences (MDs) for continuous variables and relative risk differences (RD) for dichotomous variables. MAIN RESULTS: We included eight trials (203 participants) in this review. Treadmill training improved gait speed (SMD 0.50; 95% confidence interval (CI) 0.17 to 0.84; P = 0.003; I(2) = 0%) (fixed-effect model), stride length (SMD 0.42; 95% CI 0.00 to 0.84; P = 0.05; I(2) = 0%), walking distance (MD = 358 metres; 95% CI 289 to 426; P < 0.0001; I(2) = 30%), but cadence did not improve (MD 1.06; 95% CI -4.32 to 6.44; P = 0.70; I(2) = 0%) at the end of study. Treadmill training did not increase the risk of patients dropping out (RD -0.07; 95% CI -0.18 to 0.05; P = 0.26; I(2) = 51%) (random-effects model). Adverse events were not reported. AUTHORS' CONCLUSIONS: Patients with Parkinson's disease who receive treadmill training are more likely to improve their impaired gait hypokinesia. However, the results must be interpreted with caution because there were variations between the trials in patient characteristics, the duration and amount of training, and types of treatment. Additionally, it is not known how long these improvements may last. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/20091652/Treadmill_training_for_patients_with_Parkinson's_disease_ L2 - https://doi.org/10.1002/14651858.CD007830.pub2 DB - PRIME DP - Unbound Medicine ER -