Article

The study investigates immediate adaptations of gait and balance to a single
session of perturbed treadmill walking in patients with Parkinson's disease. 39
Parkinson's patients in stage
1-3.5 of the Hoehn and Yahr Scale were randomized
into one of two groups, stratified by disease severity:
The experimental group
(n=19) walked on a treadmill prototype which constantly applied perturbation by
small three-dimensional tilting movements of the walking surface. The control
group (n=20) trained on the identical treadmill without perturbations. Patients
walked on the treadmill for 20min. Primary outcome measure was overground walking
speed. Secondary outcomes were postural sway during quiet standing and
spatiotemporal gait parameters during treadmill walking. Outcomes were measured
repeatedly throughout the training session and after 10min retention. The
experimental group significantly increased overground walking speed after
intervention compared to the control group (p=0.014; ES=+0.41). Gait variability
during treadmill walking significantly decreased after walking with perturbation.
Sway area increased with treadmill walking only in the control group (p=0.009;
ES=+0.49). No other postural sway measures changed over time. Subgroup analyses
revealed that in the experimental group patients with more pronounced motor
impairment demonstrated larger increases in overground walking speed (p=0.016;
ES=+0.40) and stance phase symmetry (p=0.011; ES=-0.42). In conclusion, a single
session of perturbation treadmill training led to gait improvements, which were
more pronounced compared to unperturbed treadmill walking. Effects on static
postural sway were less pronounced.
CI - Copyright (c) 2016 Elsevier B.V. All rights reserved.

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