Article

Gait and balance dysfunction are major symptoms in Parkinson's
disease (PD). Treadmill training improves gait characteristics in this population
but does not reflect the dynamic nature of controlling balance during ambulation
in everyday life contexts. OBJECTIVE: To evaluate whether postural perturbations
during treadmill walking lead to superior effects on gait and balance performance
compared with standard treadmill training. METHODS: In this single-blind
randomized controlled trial, 43 PD patients (Hoehn & Yahr stage 1-3.5) were
assigned to either an 8-week perturbed treadmill intervention (n = 21) or a
control group (n = 22) training on the identical treadmill without perturbations.
Patients were assessed at baseline, postintervention, and at 3 months' follow-up.
Primary endpoints were overground gait speed and balance (Mini-BESTest).
Secondary outcomes included fast gait speed, walking capacity (2-Minute Walk
Test), dynamic balance (Timed Up-and-Go), static balance (postural sway), and
balance confidence (Activities-Specific Balance Confidence [ABC] scale). RESULTS:
There were no significant between-group differences in change over time for the
primary outcomes. At postintervention, both groups demonstrated similar
improvements in overground gait speed ( P = .009), and no changes in the
Mini-BESTest ( P = .641). A significant group-by-time interaction ( P = .048)
existed for the Timed Up-and-Go, with improved performance only in the
perturbation group. In addition, the perturbation but not the control group
significantly increased walking capacity ( P = .038). Intervention effects were
not sustained at follow-up. CONCLUSIONS: Our primary findings suggest no superior
effect of perturbation training on gait and balance in PD patients. However, some
favorable trends existed for secondary gait and dynamic balance parameters, which
should be investigated in future trials.

Langue : ANGLAIS