Objective: To compare how three exercise interventions differentially impact gait in people with Parkinson’s disease (PD) during different gait tasks.

Background: Gait impairments are common in PD and may lead to falls and injuries. Investigators have shown that many different forms of exercise may improve gait compared to inactive or standard care controls. Given the heterogeneity of exercise interventions and lack of direct comparisons between interventions, it is unclear if one form of exercise may be superior for improving gait in people with PD.

Methods: Gait data from 98 participants (mean age: 67.1±8.9 years, 41% female) with mild to moderate idiopathic PD were analyzed before and after a 12-week exercise program. Participants were assigned to a tango (n=39), treadmill walking (n=32), or stretching (n=27) group. Participants attended one hour classes twice weekly. Gait was evaluated off anti-PD medication (i.e. ≥ 12 hour withdrawal) using a GAITRite walkway during comfortable forward (FWD), fast as possible (FAST), cognitive dual task (DUAL), and backward (BKD) gait. Six minute walk test (6MWT) and timed up and go (TUG) were included as clinical measures of gait.

Results: Significant group x time interactions (p<0.05) showed velocity and cadence increased in FWD gait with treadmill training (post hoc p<0.01) but not tango or stretching. DUAL (p<0.05) and BKD (p<0.001) velocity and stride length increased over time, regardless of group. There was a significant interaction for BKD cadence (p<0.05) where cadence increased in the stretching group only (post hoc p<0.05). FAST gait did not change. 6MWT and TUG improved in all groups over time (p<0.01).

Conclusions: Improvements in FWD gait only occurred in the treadmill group. However, all three groups improved in the more challenging BKD and DUAL tasks. The increase in cadence during BKD gait without an increase in velocity may indicate a decline in backward walking in the stretching group that was not observed with tango or treadmill. Our data support that various forms of exercise can improve gait, but different types of exercise may preferentially help with specific gait deficits. Future research should focus on optimizing dosing of exercise interventions and examining whether there are common characteristics of people with PD who improve with different types of exercise.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/differential-effects-of-tango-treadmill-and-stretching-interventions-on-gait-in-people-with-parkinsons-disease/