Objective: Assess the effects of non-motorized treadmill training for one session on gait parameters and fall risk in individuals with Parkinson’s disease.

Background: Parkinson’s disease (PD) is a complex disorder characterized by non-motor and motor impairments.  Within the motor-impairments, mobility deficits resulting from gait abnormalities and postural instability are some of the challenging characteristics that are associated with PD.  Without physical activity, those with PD are at risk for decline in function.  Motorized treadmill (MT) training is the most frequently used exercise modality in those with PD, as it is comparable to daily ambulation. Recently, non-motorized treadmill (NMT) training has become a point of interest among clinicians attempting to increase intensity while treadmill training.

Method: 16 participants diagnosed with PD H&Y (I-III) mean age 73.3 ± 4.8 completed two treadmill training sessions.  Beginning with two-minutes at self-selected (SS) gait speed, followed by six-minutes of intense treadmill training at 110% of SS up to fastest comfortable (FC) gait speed, and ended with two-minutes at SS totaling 10-minutes. The Zeno electronic walkway measured gait parameters while fall risk was assessed using the Modified Four Step Square Test (mFSST) and the Timed Up and Go (TUG) at pre-test, immediate posttest, and 20-minute follow-up.  Perceived exertion was measured using the Borg Rate of Perceived Exertion (Borg).

Results: NMT met the minimal clinically important difference (MCID) of 0.06 m/s for SS (0.12m/s) and FC (0.06 m/s) while MT met MCID for FC gait speed (0.11 m/s). A moderate effect size (0.45) was found following NMT for SS gait speed. The interaction between time and treadmill on mFSST was not significantly different (p = 0.47). Interestingly, following the 6-minutes of intense training, Borg ratings peaked at 14.06 “hard” following MT and 16.13 “very hard” following NMT which remained elevated at 15.87 upon completion of training.

Conclusion: The effects of one session of NMT and MT training did result in perceived meaningful improvements in SS and FC gait speed, however these improvements were not statistically significant. This study found a significant difference between treadmills when assessing intensity during treadmill sessions. This study supports the feasibility of intense treadmill training using NMT for individuals with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/immediate-effects-of-non-motorized-treadmill-training-for-one-session-on-gait-and-fall-risk-in-parkinsons-disease/