Clinical Trial ARTICLE
BODY WEIGHT SUPPORT COMBINED WITH TREADMILL IN THE REHABILITATION OF PARKINSONIAN GAIT: A REVIEW OF LITERATURE AND NEW DATA FROM A CONTROLLED STUDY
- 1Dipartimento di Neurologia e Neuroriabilitazione, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Italy
- 2Dipartimento di Scienze del Sistema Nervoso e del Comportamento, Università di Pavia, Italy
Background. Gait disorders represent disabling symptoms in Parkinson's Disease (PD). The effectiveness of rehabilitation treatment with Body Weight Support Treadmill Training (BWSTT) has been demonstrated in patients with stroke and spinal cord injuries, but limited data is available in PD.
Aims. The aim of the study is to investigate the efficacy of BWSTT in the rehabilitation of gait in PD patients.
Methods. Thirty-six PD inpatients were enrolled and performed rehabilitation treatment for 4 weeks, with daily sessions. Subjects were randomly divided into two groups: both groups underwent daily 40-minute sessions of traditional physiokinesitherapy followed by 20-minute sessions of overground gait training (Control group) or BWSTT (BWSTT group). The efficacy of BWSTT was evaluated with clinical scales and Computerized Gait Analysis (CGA). Patients were tested at baseline (T0) and at the end of the 4-week rehabilitation period (T1).
Results. Both BWSTT and Control groups experienced a significant improvement in clinical scales as FIM and UPDRS and in gait parameters for both interventions. Even if we failed to detect any statistically significant differences between groups in the different clinical and gait parameters, the intragroup analysis captured a specific pattern of qualitative improvement associated to cadence and stride duration for the BWSTT group and to the swing/stance ratio for the Control Group. Four patients with chronic pain or anxious symptoms did not tolerate BWSTT.
Conclusions. BWSTT and traditional rehabilitation treatment are both effective in improving clinical motor functions and kinematic gait parameters. BWSTT may represent an option in PD patients with specific symptoms that limit traditional overground gait training, e.g. severe postural instability, balance disorder, orthostatic hypotension. BWSTT is generally well tolerated, though caution is needed in subjects with chronic pain or with anxious symptoms.
Keywords: Body weight support treadmill training, Gait rehabilitation, computerized gait analysis, Parkinson's disease (PD), Neurorehabilitation
Received: 10 Sep 2018;
Accepted: 23 Nov 2018.
Edited by:Giovanni Abbruzzese, Università di Genova, Italy
Reviewed by:Domenico A. Restivo, Ospedale Garibaldi, Italy
Marianna Capecci, Università Politecnica delle Marche, Italy
Copyright: © 2018 Berra, De Icco, Avenali, Dagna, Cristina, Pacchetti, Fresia, Sandrini and Tassorelli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: MD. Roberto De Icco, Dipartimento di Neurologia e Neuroriabilitazione, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Pavia, Lombardy, Italy, firstname.lastname@example.org