Treadmill helps Parkinson's patients walk better

NEW YORK (Reuters Health) - Treadmill training can help Parkinson's patients to walk more normally, according to a new review of the medical literature.

However, it's unclear how long the benefits of treadmill training will last, or the best way to deliver this type of training to patients with the movement disorder, Dr. Jan Mehrholz of the Wissenschaftliches Institut in Kreischa, Germany and colleagues note.

In Parkinson's disease, neurons producing dopamine, an important chemical messenger in the brain, die off, leading to movement problems, tremor and rigidity. Many Parkinson's patients have a characteristic shuffling gait, which can boost their risk of falls and fractures.

Treadmill training has been used to help improve gait in Parkinson's patients, but more information is needed on its effectiveness and safety, Mehrholz and colleagues say. To investigate, they identified eight studies that compared treadmill training to no treadmill training in a total of 203 Parkinson's patients.

Their analysis found that training significantly improved walking speed, stride length and walking distance. However, it did not improve the "cadence," or rhythm, of a patient's gait.

The evidence should be interpreted with caution, Mehrholz and colleagues say, because it's based on only eight small studies.

"There is still a need for larger trials to establish if treadmill training can be safely used as a routine therapy for Parkinson's patients," Mehrholz said in a statement accompanying the study published in The Cochrane Library, a publication of the Cochrane Collaboration, an international non-profit that evaluates medical research.

"We also need to answer basic questions," Mehrholz said, "about how long the benefits last and what a good training program should consist of. For instance, how often and how long should patients train for?"

SOURCE: The Cochrane Library 2010.