Therapeutic Influence of Treadmill Therapy vs. Physiotherapy without Treadmill in Dual-Task-Behavior while walking in Parkinson’s Patients

Phase 2

• Conditions: G20.0; G20.1

• Registration Number: DRKS00018841
• Lead Sponsor: Förderverein Parkinson-Hilfe e. V.

Brief Summary

Motor-cognitive dual tasks are used to investigate the interplay between gait and cognition. Dual task walking in patients with Parkinson’s disease (PD) results in decreased gait speed and more importantly in an increased fall risk. There is evidence that physical training may improve gait during dual task challenge. Physiotherapy and treadmill walking are known to improve single task gait. The aim of this study was to investigate the impact of individualized physiotherapy or treadmill training on gait during dual task performance. 105 PD patients were randomly assigned to an intervention group (physiotherapy or treadmill). Both groups received 10 individual interventional sessions of 25 min each and additional group therapy sessions for 14 days. Primary outcome measure was the dual task gait speed. Secondary outcomes were additional gait parameters during dual task walking, UPDRS-III, BBS and walking capacity. All gait parameters were recorded using sensor-based gait analysis. Gait speed improved significantly by 4.2% (treadmill) and 8.3% (physiotherapy). Almost all secondary gait parameters, UPDRS-III, BBS, and walking capacity improved significantly and similarly in both groups. However, interaction effects were not observed. Both interventions significantly improved gait in patients with mild to moderate PD. However, treadmill walking did not show significant benefits compared to individualized physiotherapy. Our data suggest that both interventions improve dual task walking and therefore support safe and independent walking. This result may lead to more tailored therapeutic preferences.

Detailed Description

Not available

Study Timeline

• Study Start: 2019-10-23
• Study Completion: 2021-06-21
• Results First Posted: 2022-06-13
• Last Update Posted: 19 August 2024

Recruitment & Eligibility

• Status: Complete
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

Idiopathic Parkinson‘s-Syndrome (according to the MDS Criteria Postuma, RB et al. MDS clinical diagnostic criteria for Parkinson’s disease. Mov. Disord. 30, 1591–1601 (2015)).
• Hoehn & Yahr Stages I-III
• Age 30-90 years
• Independent walking on a treadmill for a duration of 25 minutes
• Patients had to be able to comprehend the demands required of them

Exclusion Criteria

• Atypical or secondary Parkinson‘s Syndrome
• Freezing
• Extreme motor fluctuations and end-of-dose-phenomena
• Acute orthopedic gait-limiting factors
• Central and peripheral paresis
• Extreme axial posturing (z. B. Pisa-Syndrome, Camptocormia)
• Previously diagnosed dementia according to anamnestic information
• Acute cardial symptoms
• Incidence of falls
• Acute psychiatric symptoms

Study & Design

• Study Type: interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Primary Parameters:<br>•walking analysis /speed of walking while performing dual-tasks<br>•clinically relevant, sensor-based gait parameters (such as speed of walking, step length, stance phase vs. swing phase

Secondary Outcome Measures

Name	Time	Method
•UPDRS-MDS Motor Score III (nach Fahn S., <br> Elton RL, and members of the UPDRS <br> Development Committee. Unified <br> Parkinson`s disease rating scale. In: Fahn S, <br> Marsden CD, Goldstein M, Calne DB, eds. <br> Recent deve-lopments in Parkinson`s <br> disease. New York: Macmillan, 1987:153-163<br>•Berg Balance Scale (BBS) (nach Scherfer et <br> al. 2006)