This study aimed to investigate the effects of adding aerobic or resistance exercise after treadmill gait training on walking performance in people with PD.
This study was a single-blinded randomized controlled trial. People with idiopathic PD were recruited and randomly allocated into the aerobic exercise (AEX) group, resistance exercise (REX) group, or control (CON) group. Participants received 12 sessions of 30-minute treadmill gait training within 4 to 6 weeks. Immediately following treadmill training, the AEX group performed moderately high-intensity bicycle training for 20 minutes, while the REX group received resistance training for 20 minutes. The CON group, on the other hand, sat on a chair and rested. Gait parameters, including gait velocity, cadence, stride length, and heel strike angle, were recorded as primary outcomes. Secondary outcomes included the motor subscale of the Unified Parkinson’s Disease Rating Scale (UPDRS-III), Montreal Cognitive Assessment (MoCA), 6-minute Walk Test (6MWT), and Timed Up-and-Go test (TUG). All outcomes were assessed before interventions (pretest), after 12 intervention sessions (posttest), and one month after intervention (follow-up test). Two-way mixed model repeated measure analysis of variance was used for statistical analysis.
Forty-four participants completed all the training and the follow-up test. After training, all three groups showed significant improvement in gait velocity (p = 0.005), stride length (p = 0.001), and heel strike angle (p = 0.033) without intergroup differences and interactions, and the improvements maintained till the follow-up test. The results of secondary outcomes indicated significant time main effects in UPDRS-III (p 0.001), MoCA score (p 0.001), 6MWT (p = 0.042), 5TSTS (p = 0.017), and TUG (p = 0.028), but neither group main effects nor interactions were noted.
Our results showed that neither aerobic exercise nor resistance exercise applied after gait training facilitated greater gait improvement as compared to the no exercise control group, suggesting that 12 sessions of 30-minute treadmill training alone is sufficient to induce gait improvement in PD.
Adding aerobic or resistance exercise after skill-based gait training did not enhance greater gait improvement for people with PD. When designing training regimen, clinicians should consider the necessity of having multiple training programs in one treatment session as well as the treatment dosage provided in each session in order to achieve the most efficient and effective treatment effects.
gait training
motor learning
