Article

INTRODUCTION: Treadmill training is used in rehabilitation might improve gait
parameters of patients with Parkinson Disease. Aim of this study was to assess
the effectiveness of treadmill training in improving the gait of patients with
Parkinson Disease and the acceptability and safety of this type of therapy.
EVIDENCE ACQUISITION: We searched the Cochrane Movement Disorders Group
Specialized Register (last searched September 2014), Cochrane Central Register of
Controlled Trials (The Cochrane Library 2014, Issue 10), MEDLINE (1950 to
September 2014), and EMBASE (1980 to September 2014). We also handsearched
relevant conference proceedings, searched trials and research registers, and
checked reference lists (last searched September 2014). We contacted trialists,
experts and researchers in the field and manufacturers of commercial devices. We
included all randomized controlled trials comparing treadmill training with no
treadmill training in patients with Parkinson Disease. Two review authors
independently selected trials for inclusion, assessed trial quality and extracted
data. EVIDENCE SYNTHESIS: Treadmill training improved gait speed (MD=0.09 m/s;
95% confidence interval (CI) 0.03 to 0.14; P=0.001; I2=24%; moderate quality of
evidence), stride length (MD=0.05 meters; 95% CI 0.01 to 0.09; P=0.01; I2=0%; low
quality of evidence), but walking distance (MD=48.9 meters; 95% CI -1.32 to
99.14; P=0.06; I2=91%; very low quality of evidence) and cadence did not improve
(MD=2.16 steps/minute; 95% CI -0.13 to 4.46; P=0.07; I2=28%; low quality of
evidence) at the end of study. Treadmill training did not increase the risk of
patients dropping out from intervention (RD=-0.02; 95% CI -0.06 to 0.02; P=0.32;
I2=13%; moderate quality of evidence) and adverse events were not reported.
CONCLUSIONS: This systematic review provides evidence from eighteen trials with
moderate to low risk of bias that the use of treadmill training in patients with
PD may improve clinically relevant gait parameters such as gait speed and stride
length. This apparent benefit for patients is, however, not supported by all
secondary variables (e.g. cadence and walking distance). The results must be
interpreted with caution because the results were heterogeneous and it is not
known how long improvements last and differences between the trials in terms of
patient characteristics, duration and amount of training and types of treadmill
training exists.

Langue : ANGLAIS

Tiré à part : OUI