Fernández-Del-Olmo Miguel Angel, Sanchez Jose Andres, Bello Olalla, Lopez-Alonso Virginia, Márquez Gonzalo, Morenilla Luis, Castro Xabier, Giraldez Manolo, Santos-García Diego
Faculty of Sciences of Sport and Physical Education, Department of Physical Education, University of A Coruña , A Coruña , Spain.
Physical Therapy Department, University School of Physical Therapy, University of A Coruña , A Coruña , Spain.
Front Neurol. 2014 Sep 26;5:191. doi: 10.3389/fneur.2014.00191. eCollection 2014.
Gait disturbances are one of the principal and most incapacitating symptoms of Parkinson's disease (PD). In addition, walking economy is impaired in PD patients and could contribute to excess fatigue in this population. An important number of studies have shown that treadmill training can improve kinematic parameters in PD patients. However, the effects of treadmill and overground walking on the walking economy remain unknown. The goal of this study was to explore the walking economy changes in response to a treadmill and an overground training program, as well as the differences in the walking economy during treadmill and overground walking. Twenty-two mild PD patients were randomly assigned to a treadmill or overground training group. The training program consisted of 5 weeks (3 sessions/week). We evaluated the energy expenditure of overground walking, before and after each of the training programs. The energy expenditure of treadmill walking (before the program) was also evaluated. The treadmill, but not the overground training program, lead to an improvement in the walking economy (the rate of oxygen consumed per distance during overground walking at a preferred speed) in PD patients. In addition, walking on a treadmill required more energy expenditure compared with overground walking at the same speed. This study provides evidence that in mild PD patients, treadmill training is more beneficial compared with that of walking overground, leading to a greater improvement in the walking economy. This finding is of clinical importance for the therapeutic administration of exercise in PD.
步态障碍是帕金森病（PD）的主要且最致残的症状之一。此外，帕金森病患者的步行经济性受损，这可能导致该人群过度疲劳。大量研究表明，跑步机训练可以改善帕金森病患者的运动学参数。然而，跑步机行走和地面行走对步行经济性的影响仍不清楚。本研究的目的是探讨跑步机训练和地面训练计划对步行经济性的影响，以及跑步机行走和地面行走时步行经济性的差异。22名轻度帕金森病患者被随机分配到跑步机训练组或地面训练组。训练计划为期5周（每周3次）。我们在每个训练计划前后评估了地面行走的能量消耗。还评估了跑步机行走（训练计划前）的能量消耗。跑步机训练而非地面训练计划使帕金森病患者的步行经济性（以偏好速度进行地面行走时每距离的耗氧率）得到改善。此外，与相同速度的地面行走相比，在跑步机上行走需要更多的能量消耗。本研究提供的证据表明，在轻度帕金森病患者中，与地面行走相比，跑步机训练更有益，能使步行经济性得到更大改善。这一发现对于帕金森病运动治疗的临床应用具有重要意义。
