Advertisement

Long-term effect of body weight–supported treadmill training in Parkinson's disease: A randomized controlled trial

  • Ichiro Miyai
    Affiliations
    Neurorehabilitation Research Institute, Bobath Memorial Hospital (Miyai); and Departments of Rehabilitation (Fujimoto, Yamamoto, Ueda) and Neurology (Saito, Nozaki, Kang), Toneyama National Hospital, Osaka, Japan
    Search for articles by this author
  • Yasuyuki Fujimoto
    Affiliations
    Neurorehabilitation Research Institute, Bobath Memorial Hospital (Miyai); and Departments of Rehabilitation (Fujimoto, Yamamoto, Ueda) and Neurology (Saito, Nozaki, Kang), Toneyama National Hospital, Osaka, Japan
    Search for articles by this author
  • Hiroshi Yamamoto
    Affiliations
    Neurorehabilitation Research Institute, Bobath Memorial Hospital (Miyai); and Departments of Rehabilitation (Fujimoto, Yamamoto, Ueda) and Neurology (Saito, Nozaki, Kang), Toneyama National Hospital, Osaka, Japan
    Search for articles by this author
  • Yoshishige Ueda
    Affiliations
    Neurorehabilitation Research Institute, Bobath Memorial Hospital (Miyai); and Departments of Rehabilitation (Fujimoto, Yamamoto, Ueda) and Neurology (Saito, Nozaki, Kang), Toneyama National Hospital, Osaka, Japan
    Search for articles by this author
  • Toshio Saito
    Affiliations
    Neurorehabilitation Research Institute, Bobath Memorial Hospital (Miyai); and Departments of Rehabilitation (Fujimoto, Yamamoto, Ueda) and Neurology (Saito, Nozaki, Kang), Toneyama National Hospital, Osaka, Japan
    Search for articles by this author
  • Sonoko Nozaki
    Affiliations
    Neurorehabilitation Research Institute, Bobath Memorial Hospital (Miyai); and Departments of Rehabilitation (Fujimoto, Yamamoto, Ueda) and Neurology (Saito, Nozaki, Kang), Toneyama National Hospital, Osaka, Japan
    Search for articles by this author
  • Jin Kang
    Affiliations
    Neurorehabilitation Research Institute, Bobath Memorial Hospital (Miyai); and Departments of Rehabilitation (Fujimoto, Yamamoto, Ueda) and Neurology (Saito, Nozaki, Kang), Toneyama National Hospital, Osaka, Japan
    Search for articles by this author

      Abstract

      Miyai I, Fujimoto Y, Yamamoto H, Ueda Y, Saito T, Nozaki S, Kang J. Long-term effect of body weight–supported treadmill training in Parkinson's disease: a randomized controlled trial. Arch Phys Med Rehabil 2002;83:1370-3. Objective: To investigate whether body weight–supported treadmill training (BWSTT) is of long-term benefit for patients with Parkinson's disease (PD). Design: Randomized controlled trial. Setting: Inpatient rehabilitation unit for neurologic diseases in Japan. Participants: Twenty-four patients (Hoehn and Yahr stages 2.5 or 3) who were not demented (Mini-Mental State Examination score, >27). Interventions: Patients were randomized to receive either a 45-minute session of BWSTT (up to 20% of body weight supported) or conventional physical therapy (PT) for 3 days a week for 1 month. Main Outcome Measures: Outcome measures were evaluated at baseline and at 1, 2, 3, and 6 months. Measures included the Unified Parkinson's Disease Rating Scale (UPDRS), ambulation speed (s/10m), and number of steps taken for a 10-m walk as a parameter for stride length. Results: Four patients needed modification of medications in the follow-up period. Twenty patients (BWSTT, n=11; PT, n=9) without modified medications were analyzed for functional outcome. Age, duration of PD, gender, and doses of medications were comparable. There was no difference in the baseline UPDRS (BWSTT=33.3; PT=32.6), speed (BWSTT=10.8; PT=11.5), and steps (BWSTT=23.4; PT=22.8). The BWSTT group had significantly greater improvement than the PT group (Mann-Whitney U test, Bonferroni adjustment for multiple comparison) in ambulation speed at 1 month (BWSTT=8.5; PT=10.8; P<.005); and in the number of steps at 1 (BWSTT=20.0; PT=22.7; P<.005), 2 (BWSTT=19.5; PT=22.4; P<.005), 3 (BWSTT=20.1; PT=23.1; P<.005), and 4 months (BWSTT=21.0; PT=23.0; P=.006). Conclusions: BWSTT has a lasting effect specifically on short-step gait in PD. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Comella CL
        • Stebbins GT
        • Brown-Toms N
        • Goetz CG.
        Physical therapy and Parkinson's disease: a controlled clinical trial.
        Neurology. 1994; 44: 376-378
        • Dietz MA
        • Goetz CG
        • Stebbins GT.
        Evaluation of a modified inverted walking stick as a treatment for parkinsonians freezing episodes.
        Mov Dis. 1990; 5: 243-247
        • Dam M
        • Tonin P
        • Casson S
        • et al.
        Effects of conventional and sensory-enhanced physiotherapy on disability of Parkinson's disease patients.
        Adv Neurol. 1996; 69: 551-555
        • Thaut MH
        • McIntosh GC
        • Rice RR
        • Miller RA
        • Rathbun J
        • Brault JM.
        Rhythmic auditory stimulation in gait training for Parkinson's disease patients.
        Mov Dis. 1996; 11: 193-200
        • Feigenson JS
        • Gitlow HS
        • Greenberg SD.
        The disability oriented rehabilitation unit—a major factor influencing stroke outcome.
        Stroke. 1979; 10: 5-7
        • Smith DS
        • Goldenberg E
        • Ashburn A
        • et al.
        Remedial therapy after stroke: a randomized controlled trial.
        BMJ. 1981; 282: 517-520
        • Strand T
        • Asplund K
        • Eriksson S
        • Hügg E
        • Lithner F
        • Webster PO.
        A non-intensive stroke unit reduces functional disability and the need for long-term hospitalization.
        Stroke. 1985; 16: 29-34
        • Kaste M
        • Palomaki H
        • Sarna S.
        Where and how should elderly stroke patients be treated? A randomized trial.
        Stroke. 1995; 26: 249-253
        • Jørgensen HS
        • Nakayama H
        • Raaschou HO
        • Larsen K
        • Hübbe P
        • Olsen TS.
        The effect of a stroke unit: reductions in mortality, discharge rate to nursing home, length of hospital stay, and cost. A community-based study.
        Stroke. 1995; 26: 1178-1182
        • Price JR
        • Reding MJ.
        Physical therapy philosophies and strategies.
        in: Handbook of neurorehabilitation. Marcel Dekker, New York1994: 181-196
        • Dobkin BH.
        An overview of treadmill locomotor training with partial body weight support: a neurophysiologically sound approach whose time has come for randomized clinical trials.
        Neurorehabil Neural Repair. 1999; 13: 157-165
        • Visintin M
        • Barbeau H.
        The effects of body weight support on the locomotor pattern of spastic paretic patients.
        Can J Neurol Sci. 1989; 16: 315-325
        • Dobkin BH
        • Edgerton VR
        • Fowler E
        • Hodgson J.
        Training induces rhythmic locomotor EMG patterns in a subject with complete spinal cord injury.
        Neurology. 1992; 42: 207-208
        • Wernig A
        • Müller S.
        Laufband locomotion with body weight support improved walking in persons with severe spinal cord injuries.
        Paraplegia. 1992; 30: 229-238
        • Barbeau H
        • Danakas M
        • Arsenault B.
        The effect of locomotor training in spinal cord injured subjects: a preliminary study.
        Restor Neurol Neurosci. 1993; 5: 81-84
        • Hesse S
        • Bertelt C
        • Schaffrin A
        • Malezic M
        • Mauritz KH.
        Restoration of gait in nonambulatory hemiplegic patients by treadmill training with partial body-weight support.
        Arch Phys Med Rehabil. 1994; 75: 1087-1093
        • Hesse S
        • Bertelt C
        • Jahnke MT
        • et al.
        Treadmill training with partial body-weight support as compared to physiotherapy in non-ambulatory hemiparetic patients.
        Stroke. 1995; 26: 976-981
        • Visintin M
        • Barbeau H
        • Korner-Bitensky N
        • Mayo NE.
        A new approach to retrain gait in stroke patients through body weight support and treadmill stimulation.
        Stroke. 1998; 29: 1122-1128
        • Schindl MR
        • Forstner C
        • Kern H
        • Hesse S.
        Treadmill training with partial body weight support in nonambulatory patients with cerebral palsy.
        Arch Phys Med Rehabil. 2000; 81: 301-306
        • Miyai I
        • Fujimoto Y
        • Yamamoto H
        • et al.
        Treadmill training with partial body weight support: its effect on Parkinson's disease.
        Arch Phys Med Rehabil. 2000; 81: 849-852
        • Brooks DJ.
        The early diagnosis of Parkinson's disease.
        Ann Neurol. 1998; 44: S10-S18
        • Fahn S
        • Elton RL.
        Unified Parkinson's Disease Rating Scale.
        in: Recent developments in Parkinson's disease. Vol 2. Macmillan Healthcare Information, Florham Park (NJ)1987: 153-163
        • Morris ME
        • Iansek R
        • Matyas TA
        • Summers JJ.
        Stride length regulation in Parkinson's disease. Normalization strategies and underlying mechanisms.
        Brain. 1996; 119: 551-568
        • Platz T
        • Brown RG
        • Marsden CD.
        Training improves the speed of aimed movements in Parkinson's disease.
        Brain. 1998; 121: 505-514
        • Hanakawa T
        • Katsumi Y
        • Fukuyama H
        • et al.
        Mechanisms underlying gait disturbance in Parkinson's disease. A single photon emission computed tomography study.
        Brain. 1999; 122: 1271-1282
        • Hanakawa T
        • Fukuyama H
        • Katsumi Y
        • Honda M
        • Shibasaki H.
        Enhanced lateral premotor activity during paradoxical gait in Parkinson's disease.
        Ann Neurol. 1999; 45: 329-336
        • Hesse S.
        Treadmill training with partial body weight support in hemiparetic patients—further research needed.
        Neurorehabil Neural Repair. 1999; 13: 179-181