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Perturbation Treadmill Training Improves Clinical Characteristics of Gait and Balance in Parkinson's Disease.
J Parkinsons Dis. 2019; 9(2):413-426.JP

Abstract

BACKGROUND

Impaired gait and postural stability are cardinal motor symptoms in Parkinson's disease (PD). Treadmill training improves gait characteristics in PD.

OBJECTIVE

This study investigates if postural perturbations during treadmill training improve motor performance and particularly gait and postural stability in PD.

METHODS

This work presents secondary outcome measures of a pilot randomized controlled trial. PD patients (n = 43) recruited at the University Hospital Erlangen were randomly allocated to the experimental (perturbation treadmill training, PTT, n = 21) or control group (conventional treadmill training, CTT, n = 22). Outcome measures were collected at baseline, after 8 weeks of intervention, and 3 months follow-up. Motor impairment was assessed by the Unified Parkinson Disease Rating Scale part-III (UPDRS-III), Postural Instability and Gait Difficulty score (PIGD), and subitems 'Gait' and 'Postural stability' by an observer blinded to the randomization. Intervention effects were additionally compared to progression rates of a matched PD cohort (n = 20) receiving best medical treatment (BMT).

RESULTS

Treadmill training significantly improved UPDRS-III motor symptoms in both groups with larger effect sizes for PTT (-38%) compared to CTT (-20%). In the PTT group solely, PIGD -34%, and items 'Gait' -50%, and 'Postural stability' -40% improved significantly in comparison to CTT (PIGD -24%, 'Gait' -22%, 'Postural stability' -33%). Positive effects persisted in PTT after 3 months and appeared to be beneficial compared to BMT.

CONCLUSIONS

Eight weeks of PTT showed superior improvements of motor symptoms, particularly gait and postural stability. Sustainable effects indicate that PTT may be an additive therapy option for gait and balance deficits in PD.

Authors+Show Affiliations

Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany.Department of Sport Science and Sport (DSS), FAU Erlangen-Nürnberg, Erlangen, Germany.Department of Sport Science and Sport (DSS), FAU Erlangen-Nürnberg, Erlangen, Germany.Machine Learning and Data Analytics Lab, FAU Erlangen-Nürnberg, Erlangen, Germany. Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering, University of Freiburg, Freiburg im Breisgau, Germany.Department of Medical Informatics, Biometry and Epidemiology, FAU Erlangen-Nürnberg, Erlangen, Germany.Machine Learning and Data Analytics Lab, FAU Erlangen-Nürnberg, Erlangen, Germany.Department of Sport Science and Sport (DSS), FAU Erlangen-Nürnberg, Erlangen, Germany.Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany.Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany. Research Group Digital Health Pathways, Fraunhofer IIS, Erlangen, Germany.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30958316

Citation

Gaβner, Heiko, et al. "Perturbation Treadmill Training Improves Clinical Characteristics of Gait and Balance in Parkinson's Disease." Journal of Parkinson's Disease, vol. 9, no. 2, 2019, pp. 413-426.
Gaβner H, Steib S, Klamroth S, et al. Perturbation Treadmill Training Improves Clinical Characteristics of Gait and Balance in Parkinson's Disease. J Parkinsons Dis. 2019;9(2):413-426.
Gaβner, H., Steib, S., Klamroth, S., Pasluosta, C. F., Adler, W., Eskofier, B. M., Pfeifer, K., Winkler, J., & Klucken, J. (2019). Perturbation Treadmill Training Improves Clinical Characteristics of Gait and Balance in Parkinson's Disease. Journal of Parkinson's Disease, 9(2), 413-426. https://doi.org/10.3233/JPD-181534
Gaβner H, et al. Perturbation Treadmill Training Improves Clinical Characteristics of Gait and Balance in Parkinson's Disease. J Parkinsons Dis. 2019;9(2):413-426. PubMed PMID: 30958316.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perturbation Treadmill Training Improves Clinical Characteristics of Gait and Balance in Parkinson's Disease. AU - Gaβner,Heiko, AU - Steib,Simon, AU - Klamroth,Sarah, AU - Pasluosta,Cristian F, AU - Adler,Werner, AU - Eskofier,Bjoern M, AU - Pfeifer,Klaus, AU - Winkler,Jürgen, AU - Klucken,Jochen, PY - 2019/4/9/pubmed PY - 2020/4/28/medline PY - 2019/4/9/entrez KW - Gait analysis KW - parkinson’s disease KW - postural stability KW - treadmill training SP - 413 EP - 426 JF - Journal of Parkinson's disease JO - J Parkinsons Dis VL - 9 IS - 2 N2 - BACKGROUND: Impaired gait and postural stability are cardinal motor symptoms in Parkinson's disease (PD). Treadmill training improves gait characteristics in PD. OBJECTIVE: This study investigates if postural perturbations during treadmill training improve motor performance and particularly gait and postural stability in PD. METHODS: This work presents secondary outcome measures of a pilot randomized controlled trial. PD patients (n = 43) recruited at the University Hospital Erlangen were randomly allocated to the experimental (perturbation treadmill training, PTT, n = 21) or control group (conventional treadmill training, CTT, n = 22). Outcome measures were collected at baseline, after 8 weeks of intervention, and 3 months follow-up. Motor impairment was assessed by the Unified Parkinson Disease Rating Scale part-III (UPDRS-III), Postural Instability and Gait Difficulty score (PIGD), and subitems 'Gait' and 'Postural stability' by an observer blinded to the randomization. Intervention effects were additionally compared to progression rates of a matched PD cohort (n = 20) receiving best medical treatment (BMT). RESULTS: Treadmill training significantly improved UPDRS-III motor symptoms in both groups with larger effect sizes for PTT (-38%) compared to CTT (-20%). In the PTT group solely, PIGD -34%, and items 'Gait' -50%, and 'Postural stability' -40% improved significantly in comparison to CTT (PIGD -24%, 'Gait' -22%, 'Postural stability' -33%). Positive effects persisted in PTT after 3 months and appeared to be beneficial compared to BMT. CONCLUSIONS: Eight weeks of PTT showed superior improvements of motor symptoms, particularly gait and postural stability. Sustainable effects indicate that PTT may be an additive therapy option for gait and balance deficits in PD. SN - 1877-718X UR - https://www.unboundmedicine.com/medline/citation/30958316/Perturbation_Treadmill_Training_Improves_Clinical_Characteristics_of_Gait_and_Balance_in_Parkinson's_Disease_ L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/JPD-181534 DB - PRIME DP - Unbound Medicine ER -