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Licensed Unlicensed Requires Authentication Published by De Gruyter August 21, 2019

Effects of treadmill training on the balance, functional capacity and quality of life in Parkinson’s disease: A randomized clinical trial

  • Paria Arfa-Fatollahkhani , Afsaneh Safar Cherati EMAIL logo , Seyed Amir Hasan Habibi , Gholam Ali Shahidi , Ahmad Sohrabi and Babak Zamani



There is growing evidence that exercise modalities have considerable effects on Parkinson’s disease (PD). This trial aimed to provide a more detailed viewpoint of short-term and long-term treadmill training (TT) effects on some motor and non-motor features of PD.


In this prospective, randomized, single-blind clinical trial, 20 mild to moderate PD patients, admitted in Rasoul-e-Akram hospital in Tehran, Iran, were randomly allocated in case (11) and control (9) groups. Treadmill intervention was performed at moderate intensity with 60% of heart rate reserved (HRR) in two 30-min sessions/week for a duration of 10 weeks. Both the groups were evaluated for three times; at the baseline, 2 months later and then 2 months after the second evaluation. We assigned the Timed Up and Go test (TUG), 6-min walk test (6MW), and the SF-8 healthy questionnaire, for assessment of balance, functional capacity, and Quality of life (QoL), respectively.


Balance and functional capacity were significantly improved in the case group after the intervention (TUG p-value: 0.003, 6MW p-value: 0.003). Moreover, the long-term analysis revealed significant results as well (TUG p-value: 0.001, 6MW p-value: 0.004). Mental condition’s scores of SF-8 in cases were not statistically different in short-term follow-up (F/U). However, analysis illustrated p-value: 0.016 for long-term assessment. The intervention induced significant changes in physical condition’s scores in both of the F/Us (PC p-value: 0.013).


This study provides evidence that a TT of mild to moderate intensity has significant and persistent benefits for the balance, functional capacity, and QoL in PD.


The authors appreciate the Rasoul-e-Akram hospital’s Sports Medicine Department staff for their cooperation and all the patients who have participated in this study.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


[1] Herman T, Giladi N, Gruendlinger L, Hausdorff JM. Six weeks of intensive treadmill training improves gait and quality of life in patients with Parkinson’s disease: a pilot study. Arch Phys Med Rehabil 2007;88:1154–8.10.1016/j.apmr.2007.05.015Search in Google Scholar PubMed

[2] Keus S, Bloem B, Van Hilten J, Ashburn A, Munneke M. Effectiveness of physiotherapy in Parkinson’s disease: the feasibility of a randomised controlled trial. Parkinsonism Relat Disord 2007;13:115–21.10.1016/j.parkreldis.2006.07.007Search in Google Scholar PubMed

[3] Carvalho A, Barbirato D, Araujo N, Martins JV, Cavalcanti JL, Santos TM, et al. Comparison of strength training, aerobic training, and additional physical therapy as supplementary treatments for Parkinson’s disease: pilot study. Clin Interv Aging 2015;10:183.10.2147/CIA.S68779Search in Google Scholar PubMed PubMed Central

[4] Frazzitta G, Balbi P, Maestri R, Bertotti G, Boveri N, Pezzoli G. The beneficial role of intensive exercise on Parkinson disease progression. Am J Phys Med Rehabil 2013;92:523–32.10.1097/PHM.0b013e31828cd254Search in Google Scholar PubMed

[5] Gallagher DA, Schrag A. Psychosis, apathy, depression and anxiety in Parkinson’s disease. Neurobiol Dis 2012;46:581–9.10.1016/j.nbd.2011.12.041Search in Google Scholar PubMed

[6] Dashtipour K, Johnson E, Kani C, Kani K, Hadi E, Ghamsary M, et al. Effect of exercise on motor and nonmotor symptoms of Parkinson’s disease. Parkinson’s Dis 2015;2015. Article ID 586378.10.1155/2015/586378Search in Google Scholar PubMed PubMed Central

[7] Fernández-del-Olmo MA, Sanchez JA, Bello O, Lopez-Alonso V, Márquez G, Morenilla L, et al. Treadmill training improves overground walking economy in Parkinson’s disease: a randomized, controlled pilot study. Front Neurol 2014;5:191.10.3389/fneur.2014.00191Search in Google Scholar PubMed PubMed Central

[8] Trigueiro L, Gama G, Simão C, Sousa A, Godeiro JC, Lindquist A. Effects of treadmill training with load on gait in Parkinson disease: a randomized controlled clinical trial. Am J Physl Med Rehabil/Assoc Academic Physiatrists 2015;94:830–7.10.1097/PHM.0000000000000249Search in Google Scholar PubMed

[9] Tseng J, Yuan R-Y, Jeng C. Treadmill training improves forward and backward gait in early Parkinson disease. Am J Phys Med Rehabil 2015;94:811–19.10.1097/PHM.0000000000000273Search in Google Scholar PubMed

[10] Cruise K, Bucks R, Loftus A, Newton R, Pegoraro R, Thomas M. Exercise and Parkinson’s: benefits for cognition and quality of life. Acta Neurol Scand 2011;123:13–19.10.1111/j.1600-0404.2010.01338.xSearch in Google Scholar PubMed

[11] Tomlinson CL, Patel S, Meek C, Clarke CE, Stowe R, Shah L, et al. Physiotherapy versus placebo or no intervention in Parkinson’s disease. Cochrane Database Syst Rev 2012;8:CD002817.10.1002/14651858.CD002817.pub3Search in Google Scholar

[12] Tassorelli C, Buscone S, Sandrini G, Pacchetti C, Furnari A, Zangaglia R, et al. The role of rehabilitation in deep brain stimulation of the subthalamic nucleus for Parkinson’s disease: a pilot study. Parkinsonism Relat Disord 2009;15:675–81.10.1016/j.parkreldis.2009.03.006Search in Google Scholar

[13] Sobstyl M, Pasterski T, Brzuszkiewicz-Kuźmicka G, Aleksandrowicz M, Zaczyński A. The influence of unilateral subthalamic deep brain stimulation on the quality of life of patients with Parkinson’s. Turk Neurosurg 2019;29:194–204.10.5137/1019-5149.JTN.21607-17.3Search in Google Scholar

[14] Duncan RP, Van Dillen LR, Garbutt JM, Earhart GM, Perlmutter JS. Physical therapy and deep brain stimulation in Parkinson’s disease: protocol for a pilot randomized controlled trial. Pilot Feasibility Stud 2018;4:54.10.1186/s40814-018-0243-2Search in Google Scholar

[15] Lauzé M, Daneault J-F, Duval C. The effects of physical activity in Parkinson’s disease: a review. J Parkinson’s Dis 2016;6:685–98.10.3233/JPD-160790Search in Google Scholar

[16] Cheung C, Bhimani R, Wyman JF, Konczak J, Zhang L, Mishra U, et al. Effects of yoga on oxidative stress, motor function, and non-motor symptoms in Parkinson’s disease: a pilot randomized controlled trial. Pilot Feasibility Stud 2018;4:162.10.1186/s40814-018-0355-8Search in Google Scholar

[17] Hughes AJ, Ben-Shlomo Y, Daniel SE, Lees AJ. What features improve the accuracy of clinical diagnosis in Parkinson’s disease: a clinicopathologic study. Neurol 1992;42:1142.10.1212/WNL.42.6.1142Search in Google Scholar

[18] Fahn S. Members of the UPDRS development committee. Unified Parkinson’s disease rating scale. Recent Dev Parkinson’s Dis 1987;2:293–304.Search in Google Scholar

[19] 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 the movement disorder society task force on rating scales for Parkinson’s disease. Mov Disorders 2004;19:1020–8.10.1002/mds.20213Search in Google Scholar

[20] Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–98.10.1016/0022-3956(75)90026-6Search in Google Scholar

[21] Medicine ACoS. ACSM’s guidelines for exercise testing and prescription. Lippincott Williams & Wilkins, 2013.Search in Google Scholar

[22] Ware JE, Kosinski M, Dewey JE, Gandek B. How to score and interpret single-item health status measures: a manual for users of the SF-8 health survey. Lincoln, RI: QualityMetric Inc., 2001:4–19.Search in Google Scholar

[23] Tokuda Y, Okubo T, Ohde S, Jacobs J, Takahashi O, Omata F, et al. Assessing items on the SF-8 Japanese version for health-related quality of life: A psychometric analysis based on the nominal categories model of item response theory. Value Health 2009;12:568–73.10.1111/j.1524-4733.2008.00449.xSearch in Google Scholar PubMed

[24] Martin A, Chalder T, Rief W, Braehler E. The relationship between chronic fatigue and somatization syndrome: a general population survey. J Psychosom Res 2007;63:147–56.10.1016/j.jpsychores.2007.05.007Search in Google Scholar PubMed

[25] Ghafari S, Ahmadi F, Nabavi M, Anoshirvan K, Memarian R, Rafatbakhsh M. Effectiveness of applying progressive muscle relaxation technique on quality of life of patients with multiple sclerosis. J Clin Nurs 2009;18:2171–9.10.1111/j.1365-2702.2009.02787.xSearch in Google Scholar PubMed

[26] Laboratories ACoPSfCPF. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002;166:111.10.1164/ajrccm.166.1.at1102Search in Google Scholar PubMed

[27] Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther 2000;80:896–903.10.1093/ptj/80.9.896Search in Google Scholar

[28] Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142–8.10.1111/j.1532-5415.1991.tb01616.xSearch in Google Scholar PubMed

[29] Paranjape S, Chitalia D. Assessment of simple gait related dual and triple tests in predicting the risk of fall in adults above age of 50 years. Cureus 2016;8:6.10.7759/cureus.651Search in Google Scholar PubMed PubMed Central

[30] Cakit BD, Saracoglu M, Genc H, Erdem HR, Inan L. The effects of incremental speed-dependent treadmill training on postural instability and fear of falling in Parkinson’s disease. Clin Rehabil 2007;21:698–705.10.1177/0269215507077269Search in Google Scholar PubMed

[31] Mehrholz J, Kugler J, Storch A, Pohl M, Hirsch K, Elsner B. Treadmill training for patients with Parkinson’s disease. Cochrane Database Syst Rev 2015;9.10.1002/14651858.CD007830.pub3Search in Google Scholar PubMed

[32] Miyai I, Fujimoto Y, Yamamoto H, Ueda Y, Saito T, Nozaki S, et al. Long-term effect of body weight–supported treadmill training in Parkinson’s disease: a randomized controlled trial. Arch Phys Med Rehabil 2002;83:1370–3.10.1053/apmr.2002.34603Search in Google Scholar PubMed

[33] Carda S, Invernizzi M, Baricich A, Comi C, Croquelois A, Cisari CJ, et al. Robotic gait training is not superior to conventional treadmill training in parkinson disease: a single-blind randomized controlled trial. Neurorehabil Neural Repair 2012;26:1027–34.10.1177/1545968312446753Search in Google Scholar PubMed

[34] PGC DS, Domingues DD, de Carvalho LA, Allodi S, Correa C Neurotrophic factors in Parkinson’s disease are regulated by exercise: evidence-based practice 2016;363:5–15.10.1016/j.jns.2016.02.017Search in Google Scholar PubMed

[35] Herman T, Giladi N, Hausdorff J. Treadmill training for the treatment of gait disturbances in people with Parkinson’s disease: a mini-review. J Neural Transm 2009;116:307–18.10.1007/s00702-008-0139-zSearch in Google Scholar PubMed

[36] Nardo A, Anasetti F, Servello D, Porta MJ. Quantitative gait analysis in patients with Parkinson treated with deep brain stimulation: the effects of a robotic gait training. NeuroRehabilitation 2014;35:779–88.10.3233/NRE-141173Search in Google Scholar PubMed

[37] Luna N, Lucareli P, Sales V, Speciali D, Alonso A, Peterson M, et al. Treadmill training in Parkinson’s patients after deep brain stimulation: effects on gait kinematic. NeuroRehabilitation 2018;42:149–58.10.3233/NRE-172267Search in Google Scholar PubMed

Received: 2018-12-27
Accepted: 2019-04-08
Published Online: 2019-08-21

© 2019 Walter de Gruyter GmbH, Berlin/Boston

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