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The Effects of Walking and Turning and Treadmill Training on Postural Balance and Walking in People with Parkinson's Disease

  • Bang, Dae-Hyouk (Department of Physical Therapy, WonKwang University Oriental Hospital) ;
  • Jeong, Wang-Mo (Jeong In Body Exercise Trading Center)
  • Received : 2019.03.12
  • Accepted : 2019.04.29
  • Published : 2019.08.31

Abstract

Purpose: The aim of our study was to evaluate the therapeutic effects of walking and turning plus treadmill training on the functional balance and walking ability of individuals with Parkinson's disease (PD). Methods: Twenty-four participants with Stage 1 to 3 ($2.13{\pm}0.64$) PD based on the Hoehn and Yahr scale were randomly allocated to the experimental group (EG) and control group (CG), with 12 participants in each group. The measured outcomes included the motor subscale of the unified Parkinson's disease rating scale (UPDRS-M), the Berg balance scale (BBS), the Timed Up and Go (TUG) test, the 10-meter walk test (10MWT), and the 6-minute walk test (6MWT). Results: Pre-to-post intervention improvements were noted for all the outcome measures for both groups (p < 0.05). Post intervention, there was a significant improvement in the EG compared to the CG for the following measured outcomes (p < 0.05): UPDRS-M (p = 0.021; 95% CI, 0.081-6.519), BBS (p = 0.042; 95% CI, 1.375-4.541), TUG (p = 0.034; 95% CI, -3.315--0.143), 10MWT (p = 0.011; 95% CI, -2.032--0.289), and 6MWT (p = 0.002; 95% CI, 24.39-91.273). Conclusion: Our study suggests that walking and turning plus treadmill training improves balance and walking compared to treadmill training only in patients with PD.

Keywords

References

  1. Bengevoord A, Vervoort G, Spildooren J, et al. Center of mass trajectories during turning in patients with parkinson's disease with and without freezing of gait. Gait & Posture. 2016;43:54-59. https://doi.org/10.1016/j.gaitpost.2015.10.021
  2. Bloem BR, van Vugt JP, Beckley DJ. Postural instability and falls in Parkinson's disease. Advance in Neurology. 2001;87:209-223.
  3. Cakit BD, Saracoglu M, Genc H, et al. The effects of incremental speed-dependent treadmill training on postural instability and fear of falling in Parkinson's disease. Clinical Rehabilitation. 2007;21(8):698-705. https://doi.org/10.1177/0269215507077269
  4. Carpinella I, Cattaneo D, Bonora G, et al. Wearable sensor-based biofeedback training for balance and gait in parkinson disease: a pilot randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2017;98(4):622-630. https://doi.org/10.1016/j.apmr.2016.11.003
  5. Chen P, Liou D, Liou K, et al. Walking turns in parkinson's disease patients with freezing of gait: the short-term effects of different cueing strategies. International Journal of Gerontology. 2016;10:71-75. https://doi.org/10.1016/j.ijge.2014.09.004
  6. Cohen J. Statistical power analysis for the behavioral sciences, 2nd. New York. Routledge. 1988.
  7. Conradsson D, Paquette C, Lokk J, et al. Pre- and unplanned walking turns in Parkinson's disease-effects of dopaminergic medication. Neuroscience. 2017;341:18-26. https://doi.org/10.1016/j.neuroscience.2016.11.016
  8. Frazzitta G, Balbi P, Maestri R, et al. The beneficial role of intensive exercise on Parkinson disease progression. American Journal of Physical Medicine & Rehabilitation. 2013;92(6):523-532. https://doi.org/10.1097/PHM.0b013e31828cd254
  9. Gelb DJ, Oliver E, Gilman S. Diagnostic criteria for Parkinson disease. Archives of Neurology. 1999;56(1):33-39. https://doi.org/10.1001/archneur.56.1.33
  10. Glaister BC, Bernatz GC, Klute GK, et al. Video task analysis of turning during activities of daily living. Gait & Posture. 2007;25(2):289-294. https://doi.org/10.1016/j.gaitpost.2006.04.003
  11. Godi M, Franchignoni F, Caligari M, et al. Comparison of reliability, validity, and responsiveness of the mini-bestest and Berg balance scale in patients with balance disorders. Physical Therapy. 2013;93(2):158-167. https://doi.org/10.2522/ptj.20120171
  12. Handojoseno AM, Gilat M, Ly QT, et al. An EEG study of turning freeze in Parkinson's disease patients: the alteration of brain dynamic on the motor and visual cortex. Engineering in Medicine and Biology Society. 2015;2015:6618-6621.
  13. Herman T, Giladi N, Hausdorff JM. Treadmill training for the treatment of gait disturbances in people with Parkinson's disease: a mini-review. Journal of Neural Transmission. 2009;116(3):307-318. https://doi.org/10.1007/s00702-008-0139-z
  14. Huxham F, Baker R, Morris ME, et al. Footstep adjustments used to turn during walking in Parkinson's disease. Movement Disorder. 2008;23(6):817-823. https://doi.org/10.1002/mds.21932
  15. Kang TW, Lee JH, Cynn HS. Six-week nordic treadmill training compared with treadmill training on balance, gait, and activities of daily living for stroke patients: a randomized controlled trial. Journal of Stroke and Cerebrovascular Disease. 2016;25(4):848-856. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.11.037
  16. Kish SJ, Shannak K, Hornykiewicz O. Uneven pattern of dopamine loss in the striatum of patients with idiopathic parkinson's disease. Pathophysiologic and clinical implications. The New England Journal of Medicine. 1988;318(14):876-880. https://doi.org/10.1056/NEJM198804073181402
  17. Klamroth S, Steib S, Gassner H, et al. Immediate effects of perturbation treadmill training on gait and postural control in patients with Parkinson's disease. Gait & Posture. 2016;50:102-108. https://doi.org/10.1016/j.gaitpost.2016.08.020
  18. Koller WC. Treatment of early Parkinson's disease. Neurology. 2002;58(4 Suppl 1):S79-86. https://doi.org/10.1212/WNL.58.suppl_1.S79
  19. Mehrholz J, Kugler J, Storch A, et al. Treadmill training for patients with Parkinson's disease. Cochrane Database System Review. 2015;8:CD007830.
  20. Miyai I, Suzuki M, Hatakenaka M, et al. Effect of body weight support on cortical activation during gait in patients with stroke. Experimental Brain Research. 2006;169(1):85-91. https://doi.org/10.1007/s00221-005-0123-x
  21. Monteiro EP, Franzoni LT, Cubillos DM, et al. Effects of nordic walking training on functional parameters in parkinson's disease: a randomized controlled clinical trial. Scandinavian Journal of Medicine & Science in Sports. 2017;27(3):351-358. https://doi.org/10.1111/sms.12652
  22. Ni M, Signorile JF, Mooney K, et al. Comparative effect of power training and high-speed yoga on motor function in older patients with Parkinson disease. Archives of Physical Medicine and Rehabilitation. 2016;97(3):345-354. https://doi.org/10.1016/j.apmr.2015.10.095
  23. O'Keeffe ST, Lye M, Donnellan C, et al. Reproducibility and responsiveness of quality of life assessment and six minute walk test in elderly heart failure patients. Heart. 1998;80(4):377-382. https://doi.org/10.1136/hrt.80.4.377
  24. Podsiadlo D, Richardson S. The timed "up & go": a test of basic functional mobility for frail elderly persons. Journal of the American Geriatric Society. 1991;39(2):142-148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  25. Soh SE, Morris ME, McGinley JL. Determinants of health-related quality of life in Parkinson's disease: a systematic review. Parkinsonism & Related Disorders. 2011;17(1):1-9. https://doi.org/10.1016/j.parkreldis.2010.08.012
  26. Thigpen MT, Light KE, Creel GL, et al. Turning difficulty characteristics of adults aged 65 years or older. Physical Therapy. 2000;80(12):1174-1187. https://doi.org/10.1093/ptj/80.12.1174
  27. Tremblay C, Monetta L, Langlois M, et al. Intermittent theta-burst stimulation of the right dorsolateral prefrontal cortex to promote metaphor comprehension in Parkinson disease: a case study. Archives of Physical Medicine and Rehabilitation. 2016;97(1):74-83. https://doi.org/10.1016/j.apmr.2015.09.002
  28. Tuon T, Valvassori SS, Dal Pont GC, et al. Physical training prevents depressive symptoms and a decrease in brain-derived neurotrophic factor in Parkinson's disease. Brain Research Bulletin. 2014;108:106-112. https://doi.org/10.1016/j.brainresbull.2014.09.006
  29. van Loo MA, Moseley AM, Bosman JM, et al. Test-re-test reliability of walking speed, step length and step width measurement after traumatic brain injury: a pilot study. Brain Injury. 2004;18(10):1041-1048. https://doi.org/10.1080/02699050410001672314
  30. Wee JY, Bagg SD, Palepu A. The Berg balance scale as a predictor of length of stay and discharge destination in an acute stroke rehabilitation setting. Archives of Physical Medicine and Rehabilitation. 1999;80(4):448-452. https://doi.org/10.1016/S0003-9993(99)90284-8
  31. Yang WC, Hsu WL, Wu RM, et al. Motion analysis of axial rotation and gait stability during turning in people with Parkinson's disease. Gait & Posture. 2016;44:83-88. https://doi.org/10.1016/j.gaitpost.2015.10.023