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.