Treadmill walking as an external pacemaker to improve gait rhythm and stability in Parkinson's disease

TLDR

External cueing has been reported to improve stride length and gait speed in Parkinson's disease. This study examined how treadmill walking influences gait variability in PD patients. Thirty‑six PD patients (Hoehn and Yahr stage 2–2.5) and 30 controls performed three 2‑minute walking trials: level ground unassisted, level ground with a walker, and treadmill. Treadmill walking significantly reduced stride‑time and swing‑time variability in both PD patients and controls, whereas using a walker did not alter variability, indicating that the treadmill acts as an external cue to stabilize gait. © 2005 Movement Disorder Society.

Abstract

Abstract Recent reports suggest that external cueing improves stride length and gait speed in Parkinson's disease (PD). The purpose of the present study was to examine the influence of treadmill walking on gait variability. The 36 PD patients (Hoehn and Yahr stage 2–2.5) were compared to 30 controls. Subjects walked three times for 2 minutes each: (1) walking on level ground (unassisted), (2) walking on level ground while using a walker, and (3) walking on a treadmill. Stride time variability and swing time variability were significantly increased in the patients compared to the control subjects when walking on level ground with a walker. In both groups, the use of a walking aid did not significantly affect stride time variability or swing time variability, but the treadmill reduced stride time variability and swing time variability in the patients and in the controls. These results indicate that, during treadmill walking, PD subjects are able to walk with a less variable and more stable gait. Because the treadmill walking speed was set to the gait speed on level ground and because this effect was not seen with a walking aid, we suggest that the treadmill may be acting as an external cue to enhance gait rhythmicity and reduce gait variability. © 2005 Movement Disorder Society