ROBOTIC GAIT TRAINING VERSUS EQUAL INTENSITY TREADMILL TRAINING IN PARKINSON DISEASE: A RANDOMIZED CONTROLLED TRIAL

Introduction. There is a lack of evidence about the most effective strategy for training gait in mild to moderate Parkinson disease. The aim of this study was to compare the effects of robotic gait training versus equal intensity treadmill training and conventional physiotherapy on walking ability in patients with mild to moderate Parkinson disease. Materials and methods. Sixty patients with Parkinson disease (Hoehn and Yahr stage 3) were randomly assigned into three groups. All patients received twelve, 45-minute treatment sessions, three days a week, for four consecutive weeks. The Robotic Gait Training group (n=20) underwent robot-assisted gait training. The Treadmill Training group (n=20) performed equal intensity treadmill training without body-weight support. The Physical Therapy group (n=20) underwent conventional gait therapy according to the proprioceptive neuromuscular facilitation concept. Patients were evaluated before, after and 3 months post-treatment. Primary outcomes were the 10-meter walking test and the sixminute walking test. Results. As to the primary outcomes, robotic gait training and equal intensity treadmill training were found more effective than conventional physiotherapy after treatment, as well as no significant difference was found between robotic gait training and treadmill training. Findings were confirmed at the 3-month followup evaluation. Only patients who underwent robotic gait training obtained clinically meaningful improvements in the 10-meter walking test (0.28±0.08m/ s) and the six-minute walking test (84.75±25.85m) after treatment. Conclusions. Our findings support the hypothesis that robotic gait training may be more clinically effective for improving walking ability than equal intensity treadmill training and conventional physiotherapy in mild to moderate Parkinson disease.