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Randomized Controlled Trial
. 2022 Sep;129(9):1189-1200.
doi: 10.1007/s00702-022-02514-4. Epub 2022 Jun 13.

Treadmill training and physiotherapy similarly improve dual task gait performance: a randomized-controlled trial in Parkinson's disease

Heiko Gaßner  1   2 , Elmar Trutt  3 , Sarah Seifferth  4 , Jana Friedrich  4 , Diana Zucker  3 , Ziad Salhani  3 , Werner Adler  5 , Jürgen Winkler  4 , Wolfgang H Jost  3
Affiliations
Randomized Controlled Trial

Treadmill training and physiotherapy similarly improve dual task gait performance: a randomized-controlled trial in Parkinson's disease

Heiko Gaßner et al. J Neural Transm (Vienna). 2022 Sep.

Abstract

Motor-cognitive dual tasks are used to investigate the interplay between gait and cognition. Dual task walking in patients with Parkinson's disease (PD) results in decreased gait speed and more importantly in an increased fall risk. There is evidence that physical training may improve gait during dual task challenge. Physiotherapy and treadmill walking are known to improve single task gait. The aim of this study was to investigate the impact of individualized physiotherapy or treadmill training on gait during dual task performance. 105 PD patients were randomly assigned to an intervention group (physiotherapy or treadmill). Both groups received 10 individual interventional sessions of 25 min each and additional group therapy sessions for 14 days. Primary outcome measure was the dual task gait speed. Secondary outcomes were additional gait parameters during dual task walking, UPDRS-III, BBS and walking capacity. All gait parameters were recorded using sensor-based gait analysis. Gait speed improved significantly by 4.2% (treadmill) and 8.3% (physiotherapy). Almost all secondary gait parameters, UPDRS-III, BBS, and walking capacity improved significantly and similarly in both groups. However, interaction effects were not observed. Both interventions significantly improved gait in patients with mild to moderate PD. However, treadmill walking did not show significant benefits compared to individualized physiotherapy. Our data suggest that both interventions improve dual task walking and therefore support safe and independent walking. This result may lead to more tailored therapeutic preferences.

Keywords: Dual task; Gait analysis; Parkinson’s disease; Physiotherapy; Treadmill training; Wearable sensors.

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Conflict of interest statement

ET, SS, JF, DZ, ZS, WA and WHJ declare no conflict of interest. HG and JW received an institutional research grant by the Federal Ministry of Education and Research, Germany (project: treatHSP, grant number 01GM1905) outside of the submitted work. JW reports personal fees outside of the submitted work from Zambon GmbH, BIAL Deutschland GmbH, and UCB Pharma GmbH.

Figures

Fig. 1
Fig. 1
Flow diagram
Fig. 2
Fig. 2
Primary outcome measure: change of dual task (DT) gait velocity (left) and dual task costs for gait velocity (right)
Fig. 3
Fig. 3
Secondary outcome measures: change of UPDRS-III (top left), Berg Balance Scale (BBS, bottom left) and walking distance in 2 min (bottom right). In addition, Levodopa Equivalent Daily Dose (LEDD, top right) is presented
See this image and copyright information in PMC

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