Background. People with Parkinson’s disease and freezing of gait (FOG+) have more falls, postural instability and cognitive impairment compared with FOG−. Objective. To conduct a secondary analysis of the V-TIME study, a randomized, controlled investigation showing a greater reduction of falls after virtual reality treadmill training (TT + VR) compared with usual treadmill walking (TT) in a mixed population of fallers. We addressed whether these treadmill interventions led to similar gains in FOG+ as in FOG−. Methods. A total of 77 FOG+ and 44 FOG− were assigned randomly to TT + VR or TT. Participants were assessed pre- and posttraining and at 6 months’ follow-up. Main outcome was postural stability assessed by the Mini Balance Evaluation System Test (Mini-BEST) test. Falls were documented using diaries. Other outcomes included the New Freezing of Gait Questionnaire (NFOG-Q) and the Trail Making Test (TMT-B). Results. Mini-BEST scores and the TMT-B improved in both groups after training (P = .001), irrespective of study arm and FOG subgroup. However, gains were not retained at 6 months. Both FOG+ and FOG− had a greater reduction of falls after TT + VR compared with TT (P = .008). NFOG-Q scores did not change after both training modes in the FOG+ group. Conclusions. Treadmill walking (with or without VR) improved postural instability in both FOG+ and FOG−, while controlling for disease severity differences. As found previously, TT + VR reduced falls more than TT alone, even among those with FOG. Interestingly, FOG itself was not helped by training, suggesting that although postural instability, falls and FOG are related, they may be controlled by different mechanisms.

中文翻译：

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步态冻结的帕金森病患者与没有通过虚拟现实增强的跑步机训练的患者反应不同吗？

背景。与 FOG- 相比，患有帕金森病和步态冻结 (FOG+) 的人有更多的跌倒、姿势不稳和认知障碍。客观的。为了对 V-TIME 研究进行二次分析，一项随机对照调查显示，在跌倒混合人群中，与通常的跑步机步行 (TT) 相比，虚拟现实跑步机训练 (TT + VR) 后跌倒的减少幅度更大。我们讨论了这些跑步机干预是否导致 FOG+ 与 FOG- 类似的收益。方法。总共 77 个 FOG+ 和 44 个 FOG- 被随机分配到 TT + VR 或 TT。参与者在训练前和训练后以及 6 个月的随访中进行了评估。主要结果是通过迷你平衡评估系统测试 (Mini-BEST) 测试评估的姿势稳定性。使用日记记录跌倒。其他结果包括新的冻结步态问卷 (NFOG-Q) 和路径制作测试 (TMT-B)。结果。无论研究组和 FOG 亚组如何，训练后两组的 Mini-BEST 分数和 TMT-B 均有所改善 (P = .001)。然而，收益在 6 个月时并未保留。与 TT 相比，在 TT + VR 后 FOG+ 和 FOG- 的跌倒减少幅度更大（P = .008）。在 FOG+ 组的两种训练模式后，NFOG-Q 得分没有变化。结论。跑步机行走（有或没有 VR）改善了 FOG+ 和 FOG- 的姿势不稳定性，同时控制了疾病严重程度的差异。如前所述，TT + VR 比单独使用 TT 更能减少跌倒，即使在 FOG 患者中也是如此。有趣的是，FOG 本身并没有得到训练的帮助，这表明虽然姿势不稳定，跌倒和 FOG 是相关的，