Background Freezing of gait (FOG) in Parkinson’s disease (PD) is associated with gait asymmetry and switching difficulty. A split-belt treadmill may potentially address those deficits. Objective To investigate the immediate and retention effects of one-session split-belt treadmill training (SBT) in contrast to regular tied-belt treadmill training (TBT) on gait asymmetry and adaptation in people with PD and FOG (PD + FOG) and healthy controls (HC). Additionally, to investigate differential effects of 3 SBT protocols and compare different gait adaptation outcomes. Methods PD + FOG (n = 45) and HC (n = 36) were randomized to 1 of 3 SBT groups (belt speeds’ ratio 0.75:1; 0.5:1 or changing ratios) or TBT group. Participants were tested at Pre, Post, and Retention after one treadmill training session. Gait asymmetry was measured during a standardized adaptation test on the split-belt treadmill Results SBT proved beneficial for gait adaptation in PD + FOG and HC (P < .0001); however, HC improved more. SBT with changing ratios demonstrated significant effects on gait adaptation from Pre to Post in PD + FOG, supported by strong effect sizes (d = 1.14) and improvements being retained for 24 hours. Mean step length asymmetry during initial exposure was lower in HC compared with PD + FOG (P = .035) and differentiated best between the groups. Conclusions PD + FOG improved gait adaptation after a single SBT session although effects were smaller than in HC. SBT with changing ratios was the most effective to ameliorate gait adaptation in PD + FOG. These promising results warrant future study on whether long-term SBT strengthens adaptation in PD + FOG and has potential to induce a better resilience to FOG. Clinical trial ID: NCT03725215.

中文翻译：

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一次分体式跑步机训练对帕金森病患者步态适应和步态冻结的影响

背景 帕金森病 (PD) 中步态冻结 (FOG) 与步态不对称和转换困难有关。分带式跑步机可能会解决这些缺陷。目的 研究单次分带跑步机训练 (SBT) 与常规系带跑步机训练 (TBT) 相比，对 PD 和 FOG (PD + FOG) 和健康人群步态不对称和适应的即时和保留效果。控制（HC）。此外，研究 3 SBT 协议的不同影响并比较不同的步态适应结果。方法 PD + FOG (n = 45) 和 HC (n = 36) 随机分配到 3 个 SBT 组中的 1 个组（带速比 0.75:1；0.5:1 或变化的比率）或 TBT 组。在一次跑步机训练课程后，参与者在 Pre、Post 和 Retention 阶段接受了测试。在分带式跑步机上进行的标准化适应测试中测量了步态不对称性 结果 SBT 证明有利于 PD + FOG 和 HC 的步态适应 (P < .0001)；然而，HC 的改进更多。具有变化比率的 SBT 对 PD + FOG 中从 Pre 到 Post 的步态适应有显着影响，这得到了强大的影响大小 (d = 1.14) 和 24 小时保持改善的支持。与 PD + FOG 相比，HC 中初始暴露期间的平均步长不对称性较低 (P = .035)，并且在各组之间差异最大。结论 PD + FOG 在单次 SBT 训练后改善了步态适应，尽管效果比 HC 小。改变比率的 SBT 是改善 PD + FOG 步态适应性的最有效方法。这些有希望的结果值得未来研究长期 SBT 是否会加强 PD + FOG 的适应，并有可能诱导更好的 FOG 恢复能力。临床试验编号：NCT03725215。