Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Universidade São Judas Tadeu, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2020 Nov 27;18:eRW5233. doi: 10.31744/einstein_journal/2020RW5233. eCollection 2020.
Parkinson's disease is the second most common neurodegenerative disorder in old age. Aging process for elders with Parkinson's disease can induce gait disturbances with more functional disabilities than for elders without the disease. Treadmill training as a therapy has resulted in notable effects on the gait of patients with Parkinson's disease and may be a resource for geriatric neurological rehabilitation. This review aimed to study the effects on gait after treadmill training in elderly patients with Parkinson's disease. The search was performed in the databases PubMed®, LILACS, PEDro and EMBASE, with the following keywords: "Parkinson's disease", "elderly", "treadmill training" and "gait evaluation". The quality of the studies included was assessed by PEDro Scale. Eleven studies met the inclusion and exclusion criteria. Eight studies were randomized, and only one did a follow-up. One can observe in this review that treadmill training with or without weight support (at least 20 minutes, two to three times a week, with progressive increase of loads, for minimum of 6 weeks) in elderly patients with the Parkinson's disease was effective to improve gait. In addition, both were considered safe (since some studies described the use of belts, even in unsupported training) and can be associated with therapies complementary to gait, such as repetitive transcranial magnetic stimulation, visual cues or anodal transcranial direct current stimulation. Treadmill training in elderly patients with Parkinson's disease is an intervention that improves gait outcomes, but further studies are required for better proofs.
帕金森病是老年人中第二常见的神经退行性疾病。患有帕金森病的老年人的衰老过程会导致步态障碍，比没有这种疾病的老年人更具功能性残疾。跑步机训练作为一种治疗方法，对帕金森病患者的步态产生了显著影响，可能是老年神经康复的一种资源。本综述旨在研究跑步机训练对帕金森病老年患者步态的影响。在 PubMed®、LILACS、PEDro 和 EMBASE 数据库中进行了搜索，使用了以下关键词：“帕金森病”、“老年人”、“跑步机训练”和“步态评估”。通过 PEDro 量表评估纳入研究的质量。符合纳入和排除标准的研究有 11 项。其中 8 项为随机研究，仅有 1 项进行了随访。从本综述中可以看出，在帕金森病老年患者中进行有或没有体重支撑的跑步机训练（至少 20 分钟，每周 2 到 3 次，逐渐增加负荷，至少 6 周）可以有效改善步态。此外，跑步机训练被认为是安全的（因为有些研究描述了使用安全带，即使在无支撑训练中），并且可以与步态的补充疗法相结合，如重复经颅磁刺激、视觉提示或阳极经颅直流电刺激。跑步机训练是改善帕金森病老年患者步态结局的一种干预措施，但需要进一步的研究来提供更好的证据。
