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Body Weight Support Gait Training for Patients With Parkinson Disease: A Systematic Review and Meta-analyses

Published:March 05, 2021DOI:https://doi.org/10.1016/j.apmr.2021.02.016

      Abstract

      Objective

      To determine the effectiveness of body weight support (BWS) gait training to improve the clinical severity, gait, and balance in patients with Parkinson disease (PD).

      Data Sources

      A literature search was conducted until July 2020 in MEDLINE, Physiotherapy Evidence Database, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature.

      Study Selection

      Randomized controlled trials that aimed at determining the effectiveness of physical activity interventions with BWS during gait training in patients with PD.

      Data Extraction

      The methodological quality of randomized controlled trials was assessed using the Cochrane risk of bias tool (RoB 2.0). Effect size (ES) and 95% confidence intervals [CIs] were calculated for the Unified Parkinson Disease Rating Scale (UPDRS), the UPDRS section III, the 6-minute walk test (6MWT), gait parameters (ie, velocity, cadence, stride length), and the Berg Balance Scale (BBS).

      Data Synthesis

      Twelve studies were included in the systematic review. The pooled ES for the effect of BWS on total UPDRS was −0.35 (95% CI, -0.57 to −0.12; I2=1.9%, P=.418), whereas for UPDRS III it was −0.35 (95% CI, -0.68 to −0.01; I2=66.4 %, P<.001). Furthermore, the pooled ES for 6MWT was 0.56 (95% CI, −0.07 to 1.18; I2=77.1%, P=.002), for gait velocity was 0.37 (95% CI, −0.10 to 0.84); I2=78.9%, P<.001), for cadence was 0.03 (95% CI, −0.25 to 0.30; I2=0.0%, P=.930), for stride length was 1.00 (95% CI, 0.23 to 1.78; I2=79.5%, P=.001), and for BBS was 0.65 (95% CI, 0.30, 0.99; I2=51.8%, P=.042).

      Conclusions

      Interventions with BWS could improve the general and motor clinical severity of patients with PD, as well as other parameters such as stride length and balance. However, the effect does not appear to be statistically significant in improving gait parameters such as velocity, cadence, and distance.

      Keywords

      List of abbreviations:

      BBS (Berg Balance Scale), BWS (body weight support), CI (confidence interval), ES (effect size), PD (Parkinson disease), 6MWT (6-minute walk test), TT (treadmill training), UPDRS (Unified Parkinson Disease Rating Scale)
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