Long-term effect of body weight–supported treadmill training in Parkinson's disease: A randomized controlled trial

Miyai, Ichiro; Fujimoto, Yasuyuki; Yamamoto, Hiroshi; Ueda, Yoshishige; Saitô, Toshio; Nozaki, Sonoko; Kang, Jin Kyung

doi:10.1053/apmr.2002.34603

Cited by 257 publications

(237 citation statements)

References 22 publications

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“…Treadmill training is beneficial in improving gait parameters and reducing the number of falls in people with PD (Pohl et al, 2003, FrenkelToledo et al, 2005, Protas et al, 2005. Additionally, training on the treadmill with body weight support has been shown to have both immediate and long-term effects on improving gait (Miyai et al, 2000(Miyai et al, & 2002. However, no one has reported the capability of people with PD to adapt locomotor trajectory in response to stepping on a rotating platform.…”

Section: Introductionmentioning

confidence: 99%

Podokinetic after-rotation in Parkinson disease

2007

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Walking on a rotating platform for 15 minutes causes healthy subjects to involuntarily turn when walking without vision. This adaptive response, called podokinetic after-rotation (PKAR), uses the same kinematic patterns as voluntary turning suggesting that PKAR and voluntary turning share common mechanisms. The purpose of this study is to determine whether people with Parkinson disease (PD), a condition that produces substantial disability from turning difficulties, can adapt to the rotating platform. Initial testing of people with PD revealed that most were unable to step on the rotating platform for 15 continuous minutes. We thus tested a less intense version of the paradigm in eight healthy people. On one day, subjects walked on the platform for 15 continuous minutes; on another day, they walked on the platform for three 5 minutes intervals separated by 5 minute rests. After both sessions, subjects rested for 5 min. then walked in place for 30 min. without vision, while we recorded rotational velocity of PKAR. Continuous and interval protocols effectively elicited robust PKAR. We then tested eight subjects with PD and matched controls using the 5 min. interval protocol and recorded PKAR responses for 10 min. There were no significant differences between the PD and control groups. We conclude that PD subjects can adapt to the rotating platform and develop PKAR from interval training. Future studies are needed to determine whether the rotating platform may act as a rehabilitative tool to reinforce motor patterns for turning and alleviate turning difficulties in people with PD.

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Section: Introductionmentioning

confidence: 99%

Podokinetic after-rotation in Parkinson disease

2007

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“…In the last 7 years, there have been an increasing number of studies [4][5][6][7][8][9][10] that have examined the effect of treadmill exercise on PD, a debilitating and progressive neurodegenerative disease, characterized by motor slowness, stiffness, tremor, and balance dysfunction. 11,12 Improved motor performance has been reported and treadmill speeds have gradually increased from studies in which subjects trained at self-selected velocities for comfort 4,6 to speeds above overground walking velocity.…”

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confidence: 99%

The Effect of Exercise Training in Improving Motor Performance and Corticomotor Excitability in People With Early Parkinson's Disease

Fisher

Salem

et al. 2008

Archives of Physical Medicine and Rehabilitation

387

333

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Objectives-To obtain preliminary data on the effects of high-intensity exercise on functional performance in people with Parkinson's disease (PD) relative to exercise at low and no intensity; and to determine whether improved performance is accompanied by alterations in corticomotor excitability as measured through transcranial magnetic stimulation (TMS).Design-Cohort (prospective), randomized controlled trial. Setting-University-based clinical and research facilities.Participants-Thirty people with PD, 3 years or more since diagnosis, with Hoehn and Yahr stage 1 or 2.Interventions-Subjects were randomized to high-intensity exercise using body weight-supported treadmill training, low-intensity exercise, or a zero-intensity education group. Subjects completed 24 exercise sessions over 8 weeks and had 5 education classes over 8 weeks. Main Outcome Measures-UnifiedParkinson's Disease Rating Scales (UPDRS), biomechanic analysis of self-selected, fast walking, and sit-to-stand tasks; corticomotor excitability was assessed with cortical silent period durations (CSP) in response to single-pulse TMS.Results-A small improvement in total and motor UPDRS was observed in all groups. Highintensity group subjects demonstrated postexercise increases in gait speed, step and stride length, and hip and ankle joint excursion during self-selected and fast gait and improved weight distribution No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated. SuppliersPublisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptArch Phys Med Rehabil. Author manuscript; available in PMC 2010 November 22. Published in final edited form as:Arch Phys Med Rehabil. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript during sit-to-stand. Improvements in gait and sit-to-stand measures were not consistently observed in low-and zero-intensity groups. Importantly, the high-intensity group demonstrated lengthening in CSP.Conclusions-The findings suggest the dose-dependent benefits of exercise and that highintensity exercise can normalize corticomotor excitability in early PD. KeywordsBasal ganglia; Central nervous system; Neuronal plasticity; Rehabilitation; Walking Both basic research and clinical studies suggest that high intensity (ie, high repetition, velocity, complexity) is a characteristic of exercise that may be important in promoting activitydependent neuroplasticity of the injured brain, includin...

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“…While a treadmill can be used to force individuals with PD to move more rapidly, increased ground reaction forces can lead to increased joint and spine pain. Thus, harness systems have been created to protect from falling as well as un-weight individuals to minimize ground reaction forces and facilitate spinal pattern generators for walking/running (body weight supported treadmill training BWSTT) [31][32][33][34].…”

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confidence: 99%

Short Term Technology-Assisted-Aerobic Exercise (AlterGR, GlideTrakTM, Vasper) in a Community Fitness Center for Patients with Mild to Moderate Parkinson’s Disease: Subjective Perceptions and Motor Effects

Byl¹

2015

CMPH

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Long-term effect of body weight–supported treadmill training in Parkinson's disease: A randomized controlled trial

Cited by 257 publications

References 22 publications

Podokinetic after-rotation in Parkinson disease

Podokinetic after-rotation in Parkinson disease

The Effect of Exercise Training in Improving Motor Performance and Corticomotor Excitability in People With Early Parkinson's Disease

Short Term Technology-Assisted-Aerobic Exercise (AlterGR, GlideTrakTM, Vasper) in a Community Fitness Center for Patients with Mild to Moderate Parkinson’s Disease: Subjective Perceptions and Motor Effects

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