Objective: The purpose of this study is to determine the neuroplastic effects on high-intensity gait training on gait parameters, motor disease severity, and quality of life using a non-motorized treadmill in individuals with Parkinson Disease.

Background: Recent efforts in physical therapy include incorporating aspects of high-intensity training for cardiovascular benefits and improved movement mechanics. The Academy of Neurologic Physical Therapy calls for more focus on intensity training as it offers the greatest potential for promoting the effects of neuroplasticity.

Method: Three participants (mean age 64.67 ± 11.06) with PD completed a 4-week progressive high-intensity NMT training program (12 sessions) Functional outcomes included Timed Up and Go Cognitive (TUG-C), Six-Minute Walk Test (6MWT), and Three-Meter Backward Walk Test (3MBWT). A fNIRS device was used to measure relative changes in oxygenated hemoglobin (O₂Hb), which served as an indirect proxy of neuroplastic adaptations during the functional tasks.

Results: All participants met the minimum clinically important difference (MCID) of 0.06 m/s for self-selected gait speed (0.12-0.27 m/s) with average speed of 1.07 ± 0.72 m/s, and an intensity corresponding to an age-predicted heart rate max of 74.76 ± 0.12% (220 – age). Post-training, TUG-C decreased by an average 14.29%, 38.67% for the 3MBWT, while 6MWT distance increased by 11.72%. The fNIRS responses following training indicated an average reduction in O2Hb of 93.51% (TUG-C) and 2.6-fold (3MBWT), with an increase of 13.78% (6MWT).

Conclusion: This 4-week NMT program enhances gait speed, functional mobility, and endurance in participants with PD, which may be potentially driven by improved PFC neuroplasticity via task-specific O2Hb changes.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/functional-and-neuroplastic-changes-following-a-4-week-non-motorized-treadmill-training-program-a-pilot-study/