ORIGINAL PAPER
Effects of trunk mobility exercise and treadmill training on functional performance of patients with Parkinson’s disease: a single-subject experimental study
,
 
 
 
More details
Hide details
1
Department of Physical Therapy, Rehabilitation Center, Yemidam Hospital, Cheong-ju, Republic of Korea
 
2
Department of Physical Therapy, College of Health and Medical Sciences, Cheongju University, Chungbuk, Republic of Korea
 
 
Submission date: 2022-09-24
 
 
Acceptance date: 2023-03-20
 
 
Publication date: 2024-06-21
 
 
Corresponding author
Duck-Won Oh   

Cheongju University
 
 
Physiother Quart. 2024;32(2):25-31
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
This study aimed to investigate the effects of integrating treadmill training with trunk mobility exercise on functional performance in patients with Parkinson’s disease (PD).

Methods:
Fourteen patients with PD volunteered for this study. This single-subject experimental study used an A-B-C design: (A) baseline, (B) intervention-1 (trunk mobility exercise alone), and (C) intervention-2 (trunk mobility exercise and treadmill training). No intervention was performed during the A phase. Trunk mobility exercise focusing on large trunk and limb motions was performed during the B phase. The C phase included treadmill training in addition to trunk mobility exercise. Outcome measures included the 10-m walk test (10MWT), timed up-and-go (TUG) test, unified Parkinson’s disease rating scale Part III, Berg balance scale, dynamic gait index, and new activities of daily living questionnaire.

Results:
In the comparison of individual data, most participants showed improved 10 MWT and TUG test scores during the B and C phases when compared with those in the baseline phase, except for one participant for the TUG test score. Moreover, group data comparison revealed significantly improved scores for all parameters after the B phase (p < 0.05), and these gains improved synergistically after the C phase (p < 0.05).

Conclusions:
These findings suggest that trunk mobility exercises are beneficial for enhancing balance and walking function in patients with PD; furthermore, the benefits are improved synergistically by integrating treadmill training.

 
REFERENCES (38)
1.
Raj K, Kaur P, Gupta GD, Singh S. Metals associated neurodegeneration in Parkinson’s disease: insight to physiological, pathological mechanisms and management. Neurosci Lett. 2021;753:135873; doi: 10.1016/j.neulet.2021.135873.
 
2.
McDonald C, Gordon G, Hand A, Walker RW, Fisher JM. 200 years of Parkinson’s disease: what have we learnt from James Parkinson? Age Ageing. 2018;47(2):209–14; doi: 10.1093/ageing/afx196.
 
3.
Benatru I, Vaugoyeau M, Azulay J-P. Postural disorders in Parkinson’s disease. Neurophysiol Clin. 2008;38(6):459–65; doi: 10.1016/j.neucli.2008.07.006.
 
4.
Fahn S. The medical treatment of Parkinson disease from James Parkinson to George Cotzias. Mov Disord. 2015;30(1):4–18; doi: 10.1002/mds.26102.
 
5.
Rahimpour S, Gaztanaga W, Yadav AP, Chang SJ, Kru­coff MO, Cajigas I, et al. Freezing of gait in Parkinson’s disease: invasive and noninvasive neuromodulation. Neuromodulation. 2021;24(5):829–42; doi: 10.1111/ner.13347.
 
6.
Olanow CW, Stern MB, Sethi K. The scientific and clinical basis for the treatment of Parkinson disease. Neurology. 2009;72(21 Suppl 4):1–136; doi: 10.1212/WNL.0b013e3181a1d44c.
 
7.
Ferreira AFF, Binda KH, Real CC. The effects of treadmill exercise in animal models of Parkinson’s disease: a systematic review. Neurosci Biobehav Rev. 2021;131:1056–75; doi: 10.1016/j.neubiorev.2021.10.019.
 
8.
Monteiro EP, Franzoni LT, Cubillos DM, de Oliveira Fagundes A, Carvalho AR, Oliveira HB, Pantoja PD, Schuch FB, Rieder CR, Martinez FG, Peyré-Tartaruga LA. Effects of Nordic walking training on functional parameters in Parkinson’s disease: a randomized controlled clinical trial. Scand J Med Sci Sports. 2017;27.3:351–8; doi: 10.1111/sms.12652.
 
9.
Tuon T, Valvassori SS, Dal Pont GC, Paganini CS, Poz­zi BG, Luciano TF, Souza PS Quevedo J, Souza CT, Pinho RA. Physical training prevents depressive symptoms and a decrease in brain-derived neurotrophic factor in Parkinson’s disease. Brain Res Bull. 2014;108:106–12; doi: 10.1016/j.brainresbull.2014.09.006.
 
10.
Haas BM, Trew M, Castle PC. Effects of respiratory muscle weakness on daily living function, quality of life, activity levels, and exercise capacity in mild to moderate Parkinson’s disease. Am J Phys Med Rehabil. 2004;83(8):601–7; doi: 10.1097/01.phm.0000133436.61009.02.
 
11.
Fox C, Ebersbach G, Ramig L, Sapir S. LSVT LOUD and LSVT BIG: behavioral treatment programs for speech and body movement in Parkinson disease. Parkinsons Dis. 2012;2012:391946; doi: 10.1155/2012/391946.
 
12.
Janssens J, Malfroid K, Nyffeler T, Bohlhalter S, Vanbellingen T. Application of LSVT BIG intervention to address gait, balance, bed mobility, and dexterity in people with Parkinson disease: a case series. Phys Ther. 2014;94(7):1014–23; doi: 10.2522/ptj.20130232.
 
13.
McDonnell MN, Rischbieth B, Schammer TT, Seaforth C, Shaw AJ, Phillips AC. Lee Silverman Voice Treatment (LSVT)-BIG to improve motor function in people with Parkinson’s disease: a systematic review and meta-analysis. Clin Rehabil. 2018;32(5):607–18; doi: 10.1177/0269215517734385.
 
14.
Tseng IJ, Yuan RY, Jeng C. Treadmill training improves forward and backward gait in early Parkinson disease. Am J Phys Med Rehabil. 2015;94(10):811–19; doi: 10.1097/PHM.0000000000000273.
 
15.
Bang DH, Shin WS, Kim SY, Choi JD. The effects of action observational training on walking ability in chronic stroke patients: a double-blind randomized controlled trial. Clin Rehabil. 2013;27(12):1118–25; doi: 10.1177/0269215513501528.
 
16.
Mehrholz J, Kugler J, Storch A, Pohl M, Elsner B, Hirsch K. Treadmill training for patients with Parkinson’s disease. Cochrane Database Syst Rev. 2015;(8):CD007830; doi: 10.1002/14651858.CD007830.
 
17.
Kim JM, Shin IS, Yoon JS, Lee HY. Comparison of diagnostic validities between MMSE-K and K-MMSE for screening of dementia. J Korean Neuropsychiatr Assoc. 2003;42(1):124–130.
 
18.
Dobkin BH. Short-distance walking speed and timed walking distance: Redundant measures for clinical trials. Neurology. 2006;66(4):584–86; doi: 10.1212/01.wnl.0000198502.88147.dd.
 
19.
Podsiadlo D, Richardson S. The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–8; doi: 10.1111/j.1532-5415.1991.tb01616.x.
 
20.
Siderowf A, McDermot M, Kieburtz K, Blindauer K, Plumb S, Shoulson I; Parkinson Study Group. Test-retest reliability of the unified Parkinson’s disease rating scale in patients with early Parkinson’s disease: results from a multicenter clinical trial. Mov Disord. 2002;17(4):758–63; doi: 10.1002/mds.10011.
 
21.
Jonsdottir J, Cattaneo D. Reliability and validity of the dynamic gait index in persons with chronic stroke. Arch Phys Med Rehabil. 2007;88(11):1410–5; doi: 10.1016/j.apmr.2007.08.109.
 
22.
Leddy AL, Earhart GM. Functional gait assessment and balance evaluation system test: reliability, validity, sensitivity, and specificity for identifying individuals with Parkinson disease who fall. Phys Ther; 2011;91(1):102–13. doi: 10.2522/ptj.20100113.
 
23.
Lee SY, Kim SK, Cheon SM, Seo J-W, Kim MA, Kim JW. Activities of daily living questionnaire from patients’ perspectives in Parkinson’s disease: a cross-sectional study. BMC Neurol. 2016;16(1):1–7; doi: 10.1186/s12883-016-0600-9.
 
24.
Ahn WH, Ahn JS, Park EK. The functional effect of multidirectional exercise program in Parkinson disease patients. J Sport Leisure Stud. 2009;35(2):791–99.
 
25.
Orme JG, Cox ME. Analyzing single-subject design data using statistical process control charts. Soc Work. 2001;25(2):115–27; doi: 10.1093/swr/25.2.115.
 
26.
Zelada-Astudillo N, Moreno VC, Herrera-Santelices A, Barbieri FA, Zamunér AR. Effect of the combination of automated peripheral mechanical stimulation and physical exercise on aerobic functional capacity and cardiac autonomic control in patients with Parkinson’s disease: a randomized clinical trial protocol. Trials. 2021;22(1):1–12; doi: 10.1186/s13063-021-05177-w.
 
27.
Lobo MA, Moeyaert M, Cunha AB, Babik I. Single-case design, analysis, and quality assessment for intervention research. J Neurol Phys Ther. 2017;41(3):187–97; doi: 10.1097/NPT.0000000000000187.
 
28.
Lin TW, Kuo YM. Exercise benefits brain function: the monoamine connection. Brain Sci. 2013;3(1):39–53; doi: 10.3390/brainsci3010039.
 
29.
Farley BG, Fox CM, Ramig LO, McFarland DH. Intensive amplitude-specific therapeutic approaches for Parkinson’s disease toward a neuroplasticity-principled rehabilitation model. Top Geriatr Rehabil. 2008;24(2):99–114; doi: 10.1097/01.TGR.0000318898.87690.0d.
 
30.
Jung SH, Hasegawa N, Mancini M, King LA, Carlson-Kuhta P, Smulders K, Peterson DS, Barlow N, Harker G, Morris R, Lapidus J, Nutt JG, Horak FB. Effects of the agility boot camp with cognitive challenge (ABC-C) exercise program for Parkinson’s disease. NPJ Parkinsons Dis. 2020;1(6):1–8; doi: 10.1038/s41531-020-00132-z.
 
31.
Yousefi B, Tadibi V, Khoei AF, Montazeri A. Exercise therapy, quality of life, and activities of daily living in patients with Parkinson disease: a small scale quasi-randomised trial. Trials. 2009;10:67; doi: 10.1186/1745-6215-10-67.
 
32.
Miyai I, Fujimoto Y, Ueda Y, Yamamoto H, Nozaki S, Sai­to T, Kang J. Treadmill training with body weight support: Its effect on Parkinson’s disease. Arch Phys Med Rehabil. 2000;81(7):849–52; doi: 10.1053/apmr.2000.4439.
 
33.
Lehman DA, Toole T, Lofald D, Hirsch MA. Training with verbal instructional cues results in near-term improvement of gait in people with Parkinson disease. J Neurol Phys Ther. 2005;29(1):2–8; doi: 10.1097/01.NPT.0000282256.36208.cf.
 
34.
Nieuwboer A, Kwakkel G, Rochester L, Jones D, van We­gen E, Willems AM, Chavret F, Hetherington V, Baker K, Lim I. Cueing training in the home improves gait-related mobility in Parkinson’s disease: the RESCUE trial. J Neurol Neurosurg Psychiatry. 200;78(2):134–40; doi: 10.1136/jnnp.200X.097923.
 
35.
Shu HF, Yang T, Yu SX, Huang HD, Jiang LL, Gu JW, et al. Aerobic exercise for Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials. PLoS One. 2014;9(7):100503; doi: 10.1371/journal.pone.0100503.
 
36.
Goetz CG, Poewe W, Rascol O, Sampaio C, Stebbins GT, Counsell C, et al. Movement disorder society task force report on the Hoehn and Yahr staging scale: status and recommendations. Mov Disord. 2004;19(9):1020–8; doi: 10.1002/mds.20213.
 
37.
Nhu NT, Cheng YJ, Lee S-D. Effects of treadmill exercise on neural mitochondrial functions in Parkinson’s disease: a systematic review of animal studies. Biomedicines 2021;9(8):1011; doi: 10.3390/biomedicines9081011.
 
38.
Kang T-W, Oh D-W, Lee J-H, Cynn H-S. Rhythmic arm swing integrated into treadmill training in patients with chronic stroke: a single-subject experimental study. Physiother Theory Pract. 2018;34(8):613–21; doi: 10.1080/09593985.2017.1423430.
 
eISSN:2544-4395
Journals System - logo
Scroll to top