Effect of non-motorized treadmill training on gait, balance, and quality of life measures in individuals with Parkinson's disease
Parkinson’s disease (PD) is a complex disorder characterized by non-motor and motor impairments. Within the motor-impairments, mobility deficits resulting from postural instability and gait abnormalities are some of the challenging characteristics that are associated with PD. Physical therapists often use outcome measures to determine if an individual is considered a fall risk. The modified four square step test (mFSSTT) was designed to assess standing dynamic balance by replacing the canes used in the traditional four square step test with 2-inch tape. Without intervention from physical therapy, those with PD are at risk for rapid decline in function. Motorized treadmill (MT) training is the most frequently used exercise modality in those with PD, as it is comparable to daily ambulation. Recently, non-motorized treadmill (NMT) training has become a point of interest among clinicians attempting to increase intensity while treadmill training. The three purposes of this project were to evaluate the interrater reliability and validity of the mFSST, the relationship between the mFSST and outcome measures related to fall risk and quality of life, and determine the immediate effects of MT and NMT on gait parameters and fall risk after one 10-minute session in individuals with PD. The participants were tested for one day to collect data for study one and two. While those participating in study three attended two treadmill training sessions over one week. The results revealed excellent interrater and excellent test-retest reliability of the mFSST. Additionally, this study found a strong correlation between the mFSST and FSST for assessment of dynamic standing balance. To assess the effects of NMT training, the Zeno Electronic Walkway was used to measure the spatial-temporal parameters of gait. Despite there being no significant difference in gait parameters or fall risk assessments between the two types of treadmills. There was a significant difference in perceived exertion between the treadmills during the treadmill training protocol. The results indicated the mFSST is a feasible assessment to assess dynamic standing balance in individuals with PD. Additionally, NMT was found to be a feasible therapeutic intervention to increase intensity demands with treadmill training individuals with PD.