Immediate effects of speed-dependent treadmill training on gait parameters in early Parkinson's disease.

OBJECTIVE

To compare the immediate effects of different training interventions on gait parameters in patients with early Parkinson's disease (PD).

DESIGN

Randomized, multiple intervention crossover pilot study.

SETTING

A rehabilitation center for adult persons with neurologic disorders.

PARTICIPANTS

Seventeen patients with early PD (Hoehn and Yahr stages I through III) and gait disturbances.

INTERVENTION

Patients were randomly assigned to varying sequences of the following interventions over 4 consecutive days: structured speed-dependent treadmill training (STT), limited progressive treadmill training (LTT), conventional gait training (CGT), and a control intervention.

MAIN OUTCOME MEASURES

Basic gait parameters (overground walking speed and stride length at self-adapted speeds) and parameters of gait analysis based on vertical ground reaction forces.

RESULTS

STT and LTT improved all basic gait parameters and the double stance duration compared with preintervention values (P<.05). No changes were found after CGT and the control intervention (P<.05). Significantly higher gains were observed in all basic gait parameters after STT and LTT when compared with CGT and the control intervention (P<.05). Additionally, a greater reduction of double stance duration was found after STT than after the control intervention (P<.001). No significant differences in gains were observed between STT and LTT, or between CGT and the control intervention, in all gait parameters.

CONCLUSION

The main disturbances of gait in PD, namely, speed and stride length, can be improved through a single intervention of STT or LTT, but not through CGT and the control intervention.