Effects of 2 years of exercise on gait impairment in people with Parkinson Disease: The PRET-PD randomized trial

Miriam R. Rafferty*, Janey Prodoehl, Julie A. Robichaud, Fabian J. David, Cynthia Poon, Lisa C. Goelz, David E. Vaillancourt, Wendy M. Kohrt, Cynthia L. Comella, Daniel M. Corcos

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

Background and Purpose: This study presents a secondary analysis from the Progressive Resistance Exercise Training in Parkinson Disease (PRET-PD) trial investigating the effects of progressive resistance exercise (PRE) and a Parkinson disease (PD)-specific multimodal exercise program, modified Fitness Counts (mFC), on spatial, temporal, and stability-related gait impairments in people with PD. Methods: Forty-eight people with PD were randomized to participate in PRE or mFC 2 times a week for 24 months; 38 completed the study. Gait velocity, stride length, cadence, and double-support time were measured under 4 walking conditions (off-/on-medication, comfortable/fast speed). Ankle strength was also measured off- and on-medication. Twenty-four healthy controls provided comparison data at one time point. Results: At 24 months, there were no significant differences between exercise groups. Both groups improved fast gait velocity offmedication, cadence in all conditions, and plantarflexion strength off-/on-medication. Both groups with PD had more gait measures that approximated the healthy controls at 24 months than at baseline. Plantarflexion strength was significantly associated with gait velocity and stride length in people with PD at baseline and 24 months, but changes in strength were not associated with changes in gait. Discussion and Conclusions: Twenty-four months of PRE and mFC were associated with improved off-medication fast gait velocity and improved cadence in all conditions, which is important because temporal gait measures can be resistant to medications. Spatial and stability-related measures were resistant to long-term improvements, but did not decline over 24 months. Strength gains did not appear to transfer to gait.

Original languageEnglish (US)
Pages (from-to)21-30
Number of pages10
JournalJournal of Neurologic Physical Therapy
Volume41
Issue number1
DOIs
StatePublished - 2017

Keywords

  • Human movement system
  • Plantarflexors
  • Progressive resistance exercise
  • Randomized controlled trial
  • Walking

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

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