Intensive cycle ergometer training improves gait speed and endurance in patients with Parkinson’s disease: A comparison with treadmill training

Article type: Research Article

Authors: Arcolin, Ilaria^a | Pisano, Fabrizio^b | Delconte, Carmen^b | Godi, Marco^a | Schieppati, Marco^{c; d} | Mezzani, Alessandro^e | Picco, Daniele^b | Grasso, Margherita^a | Nardone, Antonio^{a; f; *}

Affiliations: [a] Posture and Movement Laboratory, Division of Physical Medicine and Rehabilitation, Scientific Institute of Veruno (NO), Fondazione Salvatore Maugeri (IRCCS), Veruno (NO), Italy | [b] Division of Neurological Rehabilitation, Scientific Institute of Veruno (NO), Fondazione Salvatore Maugeri (IRCCS), Veruno (NO), Italy | [c] Centro Studi Attività Motorie (CSAM), Fondazione Salvatore Maugeri (IRCCS), Scientific Institute of Pavia, Italy | [d] Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy | [e] Division of Cardiac Rehabilitation, Scientific Institute of Veruno (NO), Fondazione Salvatore Maugeri (IRCCS), Veruno (NO), Italy | [f] Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy

Correspondence: [*] Corresponding author: Antonio Nardone, MD, PhD, Division of Physical Medicine and Rehabilitation, Fondazione Salvatore Maugeri (IRCCS), Scientific Institute of Veruno, Via Revislate 13, 28010 Veruno (NO), Italy. Tel.: +39 0322 884930; Fax: +39 0322 884921; E-mail: antonio.nardone@fsm.it.

Abstract: Purpose:Cycle ergometer training improves gait in the elderly, but its effect in patients with Parkinson’s disease (PD) is not completely known. Methods:Twenty-nine PD inpatients were randomized to treadmill (n = 13, PD-T) or cycle ergometer (n = 16, PD-C) training for 3 weeks, 1 hour/day. Outcome measures were distance travelled during the 6-min walking test (6MWT), spatio-temporal variables of gait assessed by baropodometry, the Timed Up and Go (TUG) duration, the balance score through the Mini-BESTest, and the score of the Unified Parkinson’s Disease Rating Scale (UPDRS). Results:Sex, age, body mass index, disease duration, Hoehn-Yahr staging, comorbidity and medication did not differ between groups. At end of training, ANCOVA showed significant improvement, of similar degree, in both groups for 6MWT, speed, step length and cadence of gait, TUG, Mini-BESTest and UPDRS. Conclusions:This pilot study shows that cycle ergometer training improves walking parameters and reduces clinical signs of PD, as much as treadmill training does. Gait velocity is accompanied by step lengthening, making the gait pattern close to that of healthy subjects. Cycle ergometer is a valid alternative to treadmill for improving gait in short term in patients with PD.

Keywords: Parkinson’s Disease, aerobic exercise, treadmill, cycle ergometer, balance, gait

DOI: 10.3233/RNN-150506

Journal: Restorative Neurology and Neuroscience, vol. 34, no. 1, pp. 125-138, 2016