Rehabilitation Clinical Trial
Official title:
Evaluation of the Effectiveness of Three Different Approaches for the Rehabilitation of Gait in Patients With Parkinson's Disease: Treadmill Versus Treadmill-plus Versus Virtual Reality
Evaluation of the effectiveness of three different approaches for the rehabilitation of gait in patients with PD within a multidisciplinary, intensive rehabilitation treatment (MIRT).
Gait disorders represent one of principal hallmark of Parkinson's disease (PD). Typically,
PD patients demonstrate reduced stride length and walking speed during free ambulation,
while double support duration and cadence rate are increased. Gait disorders are generally
poorly responsive to dopaminergic treatments and are related to reduced quality of life and
augmented risk of falls. Different rehabilitation techniques based on compensatory and
learning strategies, which principally exploit the use of cues to bypass the defective basal
ganglia and to ameliorate performance through practice, have been demonstrated to be
effective in improving gait in patients with PD. Cueing techniques represent the central
core for the rehabilitation of parkinsonian gait. In this context, it has been demonstrated
that treadmill training can improve gait performance in PD patients. It probably acts as an
external cue exerting a normalizing effect on the spatiotemporal gait parameters and leading
to an enhanced gait rhythmicity and a reduced gait variability. The use of a treadmill with
visual and auditory cues (treadmill-plus) seems to lead to a better improvement in gait
parameters when compared to treadmill alone. Recently, the application of virtual reality
(VR) has been introduced in the rehabilitation of PD. The use of VR is based on the
interaction of the person with a virtual environment with the aim to promote motor learning
through enhanced perceptions (visual, auditory, and haptic inputs).
It has been widely demonstrated that a multidisciplinary, intensive, goal-based,
motor-cognitive and aerobic treatment (MIRT), specifically designed for PD patients, provide
parkinsonians with motor and functional benefits. Nevertheless, the contribution provided by
treadmill, treadmill-plus and VR on gait parameters has not been previously addressed within
MIRT.
This study aims at investigating the superiority or the non-inferiority of these different
devices in improving gait in PD patients in the context of MIRT.
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