Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 9 , Pages 1154-1158 , September 2007

Six Weeks of Intensive Treadmill Training Improves Gait and Quality of Life in Patients With Parkinson’s Disease: A Pilot Study

  • Talia Herman, MSc

      Affiliations

    • Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
  • ,
  • Nir Giladi, MD

      Affiliations

    • Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
    • Department of Physical Therapy, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
  • ,
  • Leor Gruendlinger, MSc

      Affiliations

    • Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
  • ,
  • Jeffrey M. Hausdorff, PhD

      Affiliations

    • Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
    • Department of Physical Therapy, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
    • Division on Aging, Harvard Medical School, Boston, MA.
    • Corresponding Author InformationReprint requests to Jeffrey M. Hausdorff, PhD, Laboratory for Gait & Neurodynamics, Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, 6 Weizman St, Tel-Aviv 64239, Israel

References 

  1. Ashburn A, Stack E, Pickering RM, Ward CD. A community-dwelling sample of people with Parkinson’s disease: characteristics of fallers and non-fallers. Age Ageing. 2001;30:47–52
  2. Ashburn A, Stack E, Pickering RM, Ward CD. Predicting fallers in a community-based sample of people with Parkinson’s disease. Gerontology. 2001;47:277–281
  3. Bloem BR, van Vugt JP, Beckley DJ. Postural instability and falls in Parkinson’s disease. Adv Neurol. 2001;87:209–223
  4. Hely MA, Morris JG, Traficante R, Reid WG, O’Sullivan DJ, Williamson PM. The Sydney multicentre study of Parkinson’s disease: progression and mortality at 10 years. J Neurol Neurosurg Psychiatry. 1999;67:300–307
  5. Koller WC, Glatt S, Vetere-Overfield B, Hassanein R. Falls and Parkinson’s disease. Clin Neuropharmacol. 1989;12:98–105
  6. Bloem BR, Hausdorff JM, Visser JE, Giladi N. Falls and freezing of gait in Parkinson’s disease: a review of two interconnected, episodic phenomena. Mov Disord. 2004;19:871–884
  7. Bloem BR, Grimbergen YA, Cramer M, Willemsen M, Zwinderman AH. Prospective assessment of falls in Parkinson’s disease. J Neurol. 2001;248:950–958
  8. Pickering RM, Mazibrada G, Wood BH, Gray P, Kerr GK, Bloem BR. A meta-analysis of six prospective studies of falls in Parkinson’s disease. Mov Disord. 2005;19:S262;[abstract]
  9. Wood BH, Bilclough JA, Bowron A, Walker RW. Incidence and prediction of falls in Parkinson’s disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatry. 2002;72:721–725
  10. de Boer AG, Wijker W, Speelman JD, de Haes JC. Quality of life in patients with Parkinson’s disease: development of a questionnaire. J Neurol Neurosurg Psychiatry. 1996;61:70–74
  11. Martinez-Martin P. An introduction to the concept of “quality of life in Parkinson’s disease”. J Neurol. 1998;245(Suppl 1):S2–S6
  12. Grimbergen YA, Munneke M, Bloem BR. Falls in Parkinson’s disease. Curr Opin Neurol. 2004;17:405–415
  13. Miyai I, Fujimoto Y, Ueda Y, et al. Treadmill training with body weight support: its effect on Parkinson’s disease. Arch Phys Med Rehabil. 2000;81:849–852
  14. Miyai I, Fujimoto Y, Yamamoto H, et al. Long-term effect of body weight-supported treadmill training in Parkinson’s disease: a randomized controlled trial. Arch Phys Med Rehabil. 2002;83:1370–1373
  15. Toole T, Maitland CG, Warren E, Hubmann MF, Panton L. The effects of loading and unloading treadmill walking on balance, gait, fall risk, and daily function in Parkinsonism. NeuroRehabilitation. 2005;20:307–322
  16. Pohl M, Rockstroh G, Ruckriem S, Mrass G, Mehrholz J. Immediate effects of speed-dependent treadmill training on gait parameters in early Parkinson’s disease. Arch Phys Med Rehabil. 2003;84:1760–1766
  17. Protas EJ, Mitchell K, Williams A, Qureshy H, Caroline K, Lai EC. Gait and step training to reduce falls in Parkinson’s disease. NeuroRehabilitation. 2005;20:183–190
  18. Frenkel-Toledo S, Giladi N, Peretz C, Herman T, Gruendlinger L, Hausdorff JM. Treadmill walking as an external pacemaker to improve gait rhythm and stability in Parkinson’s disease. Mov Disord. 2005;20:1109–1114
  19. Schaafsma JD, Giladi N, Balash Y, Bartels AL, Gurevich T, Hausdorff JM. Gait dynamics in Parkinson’s disease: relationship to Parkinsonian features, falls and response to levodopa. J Neurol Sci. 2003;212:47–53
  20. Hausdorff JM, Rios D, Edelberg HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil. 2001;82:1050–1056
  21. Hausdorff JM, Edelberg HK, Mitchell SL, Goldberger AL, Wei JY. Increased gait unsteadiness in community-dwelling elderly fallers. Arch Phys Med Rehabil. 1997;78:278–283
  22. Hausdorff JM, Schaafsma JD, Balash Y, Bartels AL, Gurevich T, Giladi N. Impaired regulation of stride variability in Parkinson’s disease subjects with freezing of gait. Exp Brain Res. 2003;149:187–194
  23. Baltadjieva R, Giladi N, Gruendlinger L, Peretz C, Hausdorff JM. Marked alterations in the gait timing and rhythmicity of patients with de novo Parkinson’s disease. Eur J Neurosci. 2006;24:1815–1820
  24. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state” (A practical method for grading the cognitive state of patients for the clinician). J Psychiatr Res. 1975;12:189–198
  25. Members of the UPDRS development committeeFahn S, Elton R. Unified Parkinson’s disease rating scale. In:  Fahn S,  Marsden CD,  Calne D,  Goldstein M editor. Recent developments in Parkinson’s disease. Florham Park: Macmillan Health Care Information; 1987;p. 153–163
  26. Peto V, Jenkinson C, Fitzpatrick R, Greenhall R. The development and validation of a short measure of functioning and well being for individuals with Parkinson’s disease. Qual Life Res. 1995;4:241–248
  27. Guralnik JM, Simonsick EM, Ferrucci L, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49:M85–M94
  28. Myers AM, Powell LE, Maki BE, Holliday PJ, Brawley LR, Sherk W. Psychological indicators of balance confidence: relationship to actual and perceived abilities. J Gerontol A Biol Sci Med Sci. 1996;51:M37–M43
  29. Powell LE, Myers AM. The Activities-specific Balance Confidence (ABC) Scale. J Gerontol A Biol Sci Med Sci. 1995;50:M28–M34
  30. Brink TL. Brief psychiatric screening of institutionalized aged: a review. Long Term Care Health Serv Adm Q. 1980;4:253–260
  31. Montorio I, Izal M. The Geriatric Depression Scale: a review of its development and utility. Int Psychogeriatr. 1996;8:103–112
  32. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17:37–49
  33. Gift AG. Visual analogue scales: measurement of subjective phenomena. Nurs Res. 1989;38:286–288
  34. Hausdorff JM, Cudkowicz ME, Firtion R, Wei JY, Goldberger AL. Gait variability and basal ganglia disorders: stride-to-stride variations of gait cycle timing in Parkinson’s disease and Huntington’s disease. Mov Disord. 1998;13:428–437
  35. Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, Evans WJ. High-intensity strength training in nonagenarians (Effects on skeletal muscle). JAMA. 1990;263:3029–3034
  36. Ramig LO, Sapir S, Countryman S, et al. Intensive voice treatment (LSVT) for patients with Parkinson’s disease: a 2 year follow up. J Neurol Neurosurg Psychiatry. 2001;71:493–498
  37. Ramig LO, Countryman S, O’Brien C, Hoehn M, Thompson L. Intensive speech treatment for patients with Parkinson’s disease: short-and long-term comparison of two techniques. Neurology. 1996;47:1496–1504
  38. Sapir S, Ramig LO, Hoyt P, Countryman S, O’Brien C, Hoehn M. Speech loudness and quality 12 months after intensive voice treatment (LSVT) for Parkinson’s disease: a comparison with an alternative speech treatment. Folia Phoniatr Logop. 2002;54:296–303
  39. Azulay JP, Mesure S, Amblard B, Blin O, Sangla I, Pouget J. Visual control of locomotion in Parkinson’s disease. Brain. 1999;122(Pt 1):111–120
  40. Howe TE, Lovgreen B, Cody FW, Ashton VJ, Oldham JA. Auditory cues can modify the gait of persons with early-stage Parkinson’s disease: a method for enhancing parkinsonian walking performance?. Clin Rehabil. 2003;17:363–367
  41. Lim I, Van Wegen E, de Goede C, et al. Effects of external rhythmical cueing on gait in patients with Parkinson’s disease: a systematic review. Clin Rehabil. 2005;19:695–713
  42. McIntosh GC, Brown SH, Rice RR, Thaut MH. Rhythmic auditory-motor facilitation of gait patterns in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry. 1997;62:22–26
  43. Morris ME, Iansek R, Matyas TA, Summers JJ. Stride length regulation in Parkinson’s disease (Normalization strategies and underlying mechanisms). Brain. 1996;119(Pt 2):551–568
  44. Nieuwboer A, Feys P, De Weerdt W, Dom R. Is using a cue the clue to the treatment of freezing in Parkinson’s disease?. Physiother Res Int. 1997;2:125–132
  45. Rochester L, Hetherington V, Jones D, et al. The effect of external rhythmic cues (auditory and visual) on walking during a functional task in homes of people with Parkinson’s disease. Arch Phys Med Rehabil. 2005;86:999–1006
  46. Thaut MH, McIntosh GC, Rice RR, Miller RA, Rathbun J, Brault JM. Rhythmic auditory stimulation in gait training for Parkinson’s disease patients. Mov Disord. 1996;11:193–200
  47. van Hedel HJ, Waldvogel D, Dietz V. Learning a high-precision locomotor task in patients with Parkinson’s disease. Mov Disord. 2006;21:406–411
  48. Deane KH, Ellis-Hill C, Jones D, et al. Systematic review of paramedical therapies for Parkinson’s disease. Mov Disord. 2002;17:984–991
  49. Deane KH, Jones D, Playford ED, Ben Shlomo Y, Clarke CE. Physiotherapy for patients with Parkinson’s disease: a comparison of techniques. Cochrane Database Syst Rev. 2001;(3):CD002817
  50. Rubenstein TC, Giladi N, Hausdorff JM. The power of cueing to circumvent dopamine deficits: a review of physical therapy treatment of gait disturbances in Parkinson’s disease. Mov Disord. 2002;17:1148–1160

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(07)00379-6

doi: 10.1016/j.apmr.2007.05.015

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 9 , Pages 1154-1158 , September 2007