Treadmill Training Improves Overground Walking Economy in Parkinson’s Disease: A Randomized, Controlled Pilot Study

Abstract

Gait disturbances are one of the principal and most incapacitating symptoms of Parkinson’s disease (PD). In addition, walking economy is impaired in PD patients and could contribute to excess fatigue in this population. An important number of studies have shown that treadmill training can improve kinematic parameters in PD patients. However, the effects of treadmill and overground walking on the walking economy remain unknown. The goal of this study was to explore the walking economy changes in response to a treadmill and an overground training program, as well as the differences in the walking economy during treadmill and overground walking. Twenty-two mild PD patients were randomly assigned to a treadmill or overground training group. The training program consisted of 5 weeks (3 sessions/week). We evaluated the energy expenditure of overground walking, before and after each of the training programs. The energy expenditure of treadmill walking (before the program) was also evaluated. The treadmill, but not the overground training program, lead to an improvement in the walking economy (the rate of oxygen consumed per distance during overground walking at a preferred speed) in PD patients. In addition, walking on a treadmill required more energy expenditure compared with overground walking at the same speed. This study provides evidence that in mild PD patients, treadmill training is more beneficial compared with that of walking overground, leading to a greater improvement in the walking economy. This finding is of clinical importance for the therapeutic administration of exercise in PD.

Cardiopulmonary Function and Aerobic Exercise in Parkinson's: A Systematic Review of the Literature

“…Consequently, nine studies were included in the review: one was a non-randomized controlled pilot study 14 and eight were randomized controlled trials. [15][16][17][18][19][20][21][22] Figure 1 represents the findings of the search.…”

“…The decrease in walking economy in PwP leads to excess fatigue and, in turn, could affect independence and quality of life. 24 However, only two studies 21,22 studied walking economy. Investigating walking economy could help an understanding of whether PwP needs to consume more energy to walk, and how different interventions could affect energy consumption.…”

“…Seven studies assessed the effects of aerobic training on cardiopulmonary function. Aerobic training (including walking Bergen et al 14 1 0 0 1 0 0 0 1 1 1 1 5 Bridgewater and Sharpe 18 1 1 1 1 0 0 1 1 1 1 1 8 Burini et al 16 1 1 1 1 0 0 1 1 1 1 1 8 Corbianco et al 15 1 1 1 1 0 0 0 1 1 1 1 7 Fernández-del-Olmo et al 22 1 1 0 1 0 0 0 1 1 1 1 6 Mavrommati et al 17…”

“…24 It is measured by the rate of _ VO 2 per distance during walking. 24 Only two studies 21,22 investigated the effect of aerobic training on cardiopulmonary function and walking economy in PwP. Table 3 summarizes the main findings of these two studies.…”

“…However, Schenkman's study assessed the energy required to walk on the treadmill, not on an overground surface that is more akin to functional mobility. Only one study 22 examined the effect of treadmill training and overground walking on overground walking economy in PwP. To achieve this, 22 PwP (H&Y stage I-II) were randomly allocated to an overground walking intervention group and a treadmill training group for 5 weeks.…”