Lack of Short-Term Effectiveness of Rotating Treadmill Training on Turning in People with Mild-to-Moderate Parkinson's Disease and Healthy Older Adults: A Randomized, Controlled Study

Abstract

Since turning is often impaired in Parkinson's disease (PD) and may lead to falls, it is important to develop targeted treatment strategies for turning. We determined the effects of rotating treadmill training on turning in individuals with PD. This randomized controlled study evaluated 180∘ in-place turns, functional turning (timed-up-and-go), and gait velocity before and after 15 minutes of rotating treadmill training or stepping in place in 26 people with PD and 27 age-matched controls. A subset of participants with PD (𝑛=3) completed five consecutive days of rotating treadmill training. Fast as possible gait velocity, timed-up-and-go time, 180∘ turn duration, and steps to turn 180∘ were impaired in PD compared to controls (𝑃0.05). Preferred pace gait velocity and timing of yaw rotation onset of body segments (head, trunk, pelvis) during 180∘ turns were not different in PD (𝑃>0.05) and did not change following either intervention. No improvements in gait or turning occurred after five days of rotating treadmill training, compared to one day. The rotating treadmill is not recommended for short-term rehabilitation of impaired in-place turning in the general PD population.