Treadmill training for gait rehabilitation in elderly patients with mild-to-moderate Parkinson’s disease: a systematic review and meta-analysis

Abstract

Background: Parkinson’s disease (PD), the second most prevalent neurodegenerative disorder, leads to lower extremity dysfunction that critically contributes to falls and disability, yet effective rehabilitation remains limited. Objective: Systematic assessment of the effects of treadmill training on lower limb motor performance in patients with PD. Methods: As of March 1, 2024, a systematic search was conducted in PubMed, Web of Science, Embase, and the Cochrane Library to gather randomized controlled trials (RCTs) that report the effects of treadmill training on patients with PD. Data on the Unified Parkinson’s Disease Rating Scale Part III (UPDRS-III), the Timed Up and Go test (TUG), the Berg Balance Scale (BBS),6-Minute Walk Test (6MWT),10 Meter Walk Test (10MWT), and the Parkinson’s Disease Questionnaire-39 (PDQ-39) outcome metrics, as well as general characteristics of the studies, participant demographics, and details regarding the intervention and control groups, were extracted. The Cochrane Risk of Bias tool was employed to evaluate the quality of articles at risk, while the funnel plot and Egger’s test were utilized to assess publication bias. Results: 16 RCTs comprising 582 participants were included. The meta-analysis indicated that treadmill training (TT) produced significantly better outcomes than conventional therapy (CT) in the post-intervention assessments of motor symptoms (UPDRS-III: SMD: -0.45; 95% CI: −0.73 to −0.17), and gait performance (6MWT: SMD 0.53; 95% CI: 0.08 to 0.97; 10MWT: 0.93; 95% CI: 0.54 to 1.32). Body Weight Supporting Treadmill (BBS) for Better Healing However, quality of life (PDQ-39: SMD: -0.35; 95% CI: −0.95 to 0.25), balance (BBS: SMD SMD: -0.35; 95% CI: −0.95 to 0.25; TUG: SMD: -0.35; 95% CI: −0.95 to 0.25), and treatment effects were comparable. Conclusion: TT (especially weight-supported) vs. conventional training demonstrates superior efficacy in enhancing lower limb mobility for Parkinson’s disease, improving muscular endurance and short-term gait speed, but requires enhanced dynamic balance integration. Systematic trial registration: https://www.crd.york.ac.uk/prospero/, identifier, CRD42021256958.