Improved Clinical Status, Quality of Life and Walking Capacity in Parkinson's Disease after Body-Weight Supported High-Intensity Locomotor Training

OBJECTIVE: To evaluate the effect of body-weight supported progressive high-intensity locomotor training in Parkinson's disease (PD) on: (1) clinical status; (2) quality of life; and (3) gait capacity. DESIGN: An open-label, fixed sequence cross-over study. SETTING: University motor control laboratory. PARTICIPANTS: Thirteen patients with idiopathic PD (Hoehn & Yahr 2.1) and stable medication use. INTERVENTIONS: Patients completed an eight-week (3x1hour/week) training program on a lower-body positive-pressure treadmill. Body-weight support was used to facilitate increased intensity and motor challenges during treadmill training. The training program contained combinations of 1) running and walking intervals, 2) the use of sudden changes (e.g. in body-weight support and speed), 3) different types of locomotion (e.g. chassé, skipping and jumps) and 4) sprints at 50 % body-weight. MAIN OUTCOME MEASURES: The Movement Disorders Society Unified-Parkinson's-Disease-Rating Scale (MDS-UPDRS), Parkinson's-Disease Questionnaire 39 (PDQ-39) and the six-minute walk test, eight weeks before, pre and post training. RESULTS: At the end of training, statistically significant improvements were found in all outcome measures compared to the control period. Total MDS-UPDRS changed from (mean±1SD) 58±18 to 47±18, MDS-UPDRS motor part from 35±10 to 29±12, PDQ-39 summary index from 22±13 to 13±12 and the six-minute walking distance from 576±93m to 637±90m. CONCLUSIONS: Body-weight supported progressive high-intensity locomotor training is feasible and well tolerated by patients with PD. The training improved clinical status, quality of life and gait capacity significantly.