Interventions to Improve Gait in Patients With Parkinson Disease

Certain interventions can improve gait impairment in people with Parkinson disease, according to study findings published in the Journal of Neurology.

The investigation included 148 randomized controlled trials that assessed changes in objective gait measures before and after interventions. Researchers were interested in 4 specific areas of measurement: dynamic gait, fitness, balance, and freezing of gait.

Agreement between direct and indirect evidence provided consistent evidence for all measures except balance, according to study authors.

Treatments with the largest observed effect for dynamic gait measures were aquatic therapy with dual task exercising and strength and balance training. Standardized mean differences were 1.99 for aquatic therapy with dual task exercising and 1.95 for strength and balance training, showed study results.

Fitness measures showed the largest effects with aquatic therapy and high-frequency repetitive transcranial magnetic stimulation. Standardized mean differences were 3.41 with aquatic therapy and 2.51 with high-frequency repetitive transcranial magnetic stimulation, reported researchers.

For freezing of gait, which can represent a milestone in Parkinson disease progression, results were not significant for any treatments.

“None of the studied interventions proved to be efficacious in the treatment of freezing of gait,” wrote lead author Victor Schwartz Hvingelby of the department of clinical medicine, Aarhus University, Denmark, and coauthors.

Reference:
Hvingelby VS, Glud AN, Sørensen JCH, et al. Interventions to improve gait in Parkinson’s disease: a systematic review of randomized controlled trials and network meta-analysis. J Neurol. Published online April 5, 2022. doi:10.1007/s00415-022-11091-1