Miyai, I.; Fujimoto, Y.; Ueda, Y.; Yamamoto, H.; Nozaki, S.; Saito, T.; Kang, J.  Archives of Physical Medicine and Rehabilitation  2000 Jul; 81(7): 849-52

ABSTRACT: OBJECTIVE: To test whether body weight-supported treadmill training (BWSTT) is effective in improving functional outcome of patients with Parkinson’s disease.

DESIGN: Prospective crossover trial. Patients were randomized to receive either a 4-week program of BWSTT with up to 20% of their body weightsupported followed by 4 weeks of conventional physical therapy (PT), or the same treatments in the opposite order. Medications for parkinsonism were not modified throughout the study.

SETTING: Inpatient rehabilitation unit for neurologic diseases.

SUBJECTS: Ten patients (5 men, 5 women) with Hoehn and Yahr stage 2.5 or 3 parkinsonism; mean age 67.6 years, mean duration of Parkinson’s disease 4.2 years.

MAIN OUTCOME MEASURES: The Unified Parkinson’s Disease Rating Scale (UPDRS), ambulation endurance and speed(sec/10 m), and number of steps for 10-meter walk.

RESULTS: The mean total UPDRS before/after BWSTT was 31.6/25.6, and before/after PT was 29.1/28.0. Analysis of covariance for improvement of UPDRS demonstrated a significant effect of type of therapy (F(1, 16) = 42.779, p < .0001) but not order of therapy (F(1, 16) = 0.157, p = .697 1). Patients also had significantly greater improvement with BWSTT than with PT in ambulation speed (BWSTT,before/after = 10.0/8.3; PT, 9.5/8.9), and number of steps (BWSTT, 22.3/19.6;PT, 21.5/20.8).

CONCLUSIONS: In persons with Parkinson’s disease, treadmill training with body weight support produces greater improvement in activities of daily living, motor performance, and ambulation than does physical therapy.

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