Treadmill training may be an effective form of task-specific training for improving mobility in people with Parkinson's disease and multiple sclerosis: a systematic review and meta-analysis.
Study Goal
To determine if task-specific training, such as treadmill and over-ground walking, improves mobility in individuals with progressive neurological conditions like Parkinson's disease and multiple sclerosis.
Results Summary
Treadmill training improved walking velocity, stride length, and step length in Parkinson's disease and walking endurance in multiple sclerosis, but had no effect on cadence or walking endurance in Parkinson's disease. Over-ground walking did not improve mobility in either condition.
Population
Individuals with progressive neurological conditions (Parkinson's disease and multiple sclerosis).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
treadmill training | increase | comfortable walking velocity (m/second) | people with Parkinson's disease | MD 0.21m/second, 95%CI 0.15 to 0.27 | improved | #1 |
treadmill training | increase | comfortable walking velocity (m/second) | people with multiple sclerosis | MD 0.36m/second, 95%CI 0.20 to 0.52 | improved | #2 |
treadmill training | increase | stride length (m) | people with Parkinson's disease | MD 0.12m, 95%CI 0.02 to 0.23 | improved | #3 |
treadmill training | increase | step length (m) | people with Parkinson's disease | MD 0.12m, 95%CI 0.01 to 0.23 | improved | #4 |
treadmill training | increase | walking endurance | people with multiple sclerosis | MD 26.53m, 95%CI 12.23 to 40.84 | improved | #5 |
treadmill training | no change | cadence | - | - | had no effect | #6 |
treadmill training | no change | walking endurance | people with Parkinson's disease | - | did not improve | #7 |
over-ground walking | no change | mobility | people with Parkinson's disease | - | did not improve | #8 |
over-ground walking | no change | mobility | people with multiple sclerosis | - | did not improve | #9 |
BACKGROUND: Task-specific training is an effective form of rehabilitation for improving mobility in neurological conditions. However, it remains unclear if task-specific training is effective in people with progressive disease. OBJECTIVE: To establish the efficacy of task-specific training on the mobility of individuals with progressive neurological conditions. DATA SOURCES: Electronic databases MEDLINE, EMBASE, CINAHL and Cochrane Database of Systematic Reviews. STUDY ELIGIBILITY CRITERIA: Randomised controlled trials investigating the effect of task-specific training on mobility and falls rate in individuals with progressive neurological conditions. STUDY APPRAISAL/SYNTHESIS METHODS: Risk of bias of individual studies was assessed using the Physiotherapy Evidence Database (PEDro) Scale. Mean differences (MD) and 95% confidence intervals were calculated and combined in meta-analysis. RESULTS: Analysis of 16 trials found treadmill training improved comfortable walking velocity (m/second) in people with Parkinson's disease (MD 0.21m/second, 95%CI 0.15 to 0.27) and multiple sclerosis (MD 0.36m/second, 95%CI 0.20 to 0.52). Treadmill training improved stride length (m) (MD 0.12m, 95%CI 0.02 to 0.23) and step length (m) (MD 0.12m, 95%CI 0.01 to 0.23) in people with Parkinson's disease and walking endurance in people with multiple sclerosis (MD 26.53m, 95%CI 12.23 to 40.84). Treadmill training had no effect on cadence and did not improve walking endurance in Parkinson's disease. Over-ground walking did not improve mobility in Parkinson's disease or multiple sclerosis. LIMITATIONS: Study sample sizes were small and findings must be interpreted with caution. CONCLUSION: Treadmill training may be effective for improving mobility in people with Parkinson's disease and multiple sclerosis. The effectiveness of over-ground walking is uncertain. SYSTEMATIC REVIEW PROSPERO REGISTRATION NUMBER: CRD42016047334.