The Ohio State University, College of Medicine, Division of Physical Therapy, Columbus, OH, United States.
The Ohio State University, College of Medicine, Department of Neurology, Columbus, OH, United States; The Ohio State University, College of Medicine, Department of Neuroscience, Columbus, OH, United States.
Gait Posture. 2021 May;86:186-191. doi: 10.1016/j.gaitpost.2021.03.016. Epub 2021 Mar 8.
Treadmill training may improve gait disorders associated with neurodegenerative diseases. In Parkinson's disease (PD), treadmill training alters gait patterns after one session, and long-term training improves gait parameters, fall risk, and quality of life.
What is the feasibility and safety of using this intervention for people with Lewy body dementia (LBD) or Huntington's disease (HD)?
In this observational study, 10 individuals with HD, 8 individuals with LBD, and 10 control individuals walked for 20 min on a treadmill using a speed dependent protocol starting at a slow comfortable speed and increasing incrementally toward their normal overground speed. Feasibility was determined by compliance to protocol and safety by no incidents of abnormal vital signs or expressions of distress. Changes in gait measures, Timed Up and Go (TUG) scores and quantitative motor function measures (Q-Motor; precision grasp force variability, finger and foot tapping frequency) before and after treadmill walking were analyzed using linear models.
Treadmill training is feasible and safe in LBD and HD; although, participants could not initiate treadmill walking at their comfortable overground speeds, and only 3 participants with HD were able to achieve their overground walking speed within the 20-minute session. No changes in gait measures, TUG times, and Q-Motor measures were found among LBD and HD participants after treadmill walking, although control participants demonstrated significant increases in several gait measures, and foot tap frequency (estimated difference = 0.290; p = 0.026).
Longer and more frequent treadmill sessions may be needed to see gait and motor function effects in LBD and HD. Motor and cognitive impairments associated with these diseases may make them less amenable to the effects of treadmill training.
跑步机训练可能改善与神经退行性疾病相关的步态障碍。在帕金森病（PD）中，跑步机训练在一次训练后改变步态模式，而长期训练则可以改善步态参数、跌倒风险和生活质量。
对于路易体痴呆（LBD）或亨廷顿病（HD）患者，使用这种干预措施的可行性和安全性如何？
在这项观察性研究中，10 名 HD 患者、8 名 LBD 患者和 10 名对照者使用速度相关协议在跑步机上行走 20 分钟，从一个缓慢舒适的速度开始，逐渐增加到他们正常的地面速度。通过遵守方案来确定可行性，通过没有异常生命体征或表达痛苦的事件来确定安全性。使用线性模型分析跑步机行走前后步态测量、计时起立行走（TUG）评分和定量运动功能测量（Q-Motor；精密抓握力变异性、手指和脚部敲击频率）的变化。
LBD 和 HD 患者跑步机训练是可行且安全的；尽管如此，参与者无法以舒适的地面速度开始跑步机行走，只有 3 名 HD 参与者能够在 20 分钟的训练中达到他们的地面行走速度。在 LBD 和 HD 参与者中，跑步机行走后步态测量、TUG 时间和 Q-Motor 测量均未发生变化，尽管对照组参与者在几个步态测量和脚部敲击频率方面表现出显著增加（估计差异=0.290；p=0.026）。
可能需要更长和更频繁的跑步机训练才能在 LBD 和 HD 中看到步态和运动功能的效果。这些疾病相关的运动和认知障碍可能使它们不太容易受到跑步机训练的影响。
