Article

Treadmill training has been shown to be a promising rehabilitation
strategy for improving gait and balance in persons with Parkinson disease (PD).
Most studies have involved only forward walking as an intervention. The effects
of multidirectional treadmill (forward, backward, and left and right sideways) on
gait and balance have not been reported. OBJECTIVE: To investigate the acute and
long-term effects of multidirectional treadmill training (MDTT) on gait and
balance in persons with PD, and to determine the optimal training duration.
DESIGN: Single group, repeated-measures design. SETTING: Research laboratory in a
hospital. PARTICIPANTS: Ten persons with PD (mean age 65.9 +/- 7.4 years; average
disease duration 3.90 +/- 2.18 years). INTERVENTIONS: MDTT was used. Participants
walked forward, backward, and left and right sideways for 5-7 minutes in each
direction at their fastest tolerated speed. The training was 3 days per week
continuously for 8 weeks. MAIN OUTCOME MEASUREMENTS: Gait speed, cadence, and
stride length of forward, backward and sideways walks; time and number of steps
to turn 360 degrees ; and the timed 5-step test and Timed Up-and-Go (TUG) test
were performed after the first session of MDTT and every 2 weeks. Effect size of
MDTT on each gait and balance variable was measured every 2 weeks for 8 weeks to
determine the optimal training duration. Gait and balance variables after the
first session of MDTT were compared to the baseline values (pre-MDTT) to study
the acute effect of MDTT. RESULTS: Stride length of forward, backward, and
sideways walks improved immediately after 1 session of MDTT (P = .031, .012, and
.001, respectively). The number of steps to turn and the timed 5-step test score
decreased after the first session (P = .016, and .010, respectively). Six weeks
of training was found to yield the largest mean effect size of all gait and
balance variables. At 6 weeks of MDTT, gait speed of all walking directions (P =
.001-.031), stride length of backward (P < .005) and sideways (P = .001) walks,
cadence of sideways walk (P = .036), number of steps to turn (P = .014), and
timed 5-step test (P = .033) improved from pre-MDTT measures. CONCLUSIONS: MDTT
immediately improved gait and balance in persons with PD. Six weeks of MDTT might
be the optimal training duration to improve gait and balance in the long term.
LEVEL OF EVIDENCE: IV.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS