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 and 7 others
PMID 27977518WHAT IT FOUND
Two years of either progressive resistance or multimodal balance exercise improved fast walking speed and step frequency in Parkinson's.
Neither type was superior, but stride length and stability measures did not improve, and gait remained impaired relative to healthy controls.
Key findings
01After 24 months, both exercise groups showed significant improvements in off-medication fast gait velocity and cadence, but no significant differences were found between the two groups.
02Spatial (stride length) and stability-related (double support time) gait measures did not change significantly from baseline in either group.
03Improvements in plantarflexion strength were not associated with improvements in any gait measures, suggesting strength gains did not directly drive gait changes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The trial was powered for a different primary outcome (UPDRS motor score), not for gait measures, which may have reduced the ability to detect small but clinically meaningful differences between the exercise groups. There was no control group receiving only best medical management, so it is unclear if exercise prevented decline or simply improved performance. The study did not include a task-specific gait training group, which is considered the gold standard for gait deficits. Participants had mild-to-moderate Parkinson's disease, so results may not generalize to those with more advanced disease or severe gait impairment.
Declared interests
The study was funded by the National Institute on Aging and the Parkinson's Foundation. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that progressive resistance training is superior to multimodal balance exercises for gait in Parkinson's, as the study found no significant difference between the two groups. Additionally, do not expect improvements in stride length or double support time, as these measures did not change significantly over the two-year period.