PTOTRCTJournal of neuroengineering and rehabilitation2024

Vertical locomotion improves horizontal locomotion: effects of climbing on gait and other mobility aspects in Parkinson's disease. A secondary analysis from a randomized controlled trial.

Agnes Langer, Clint Hansen, Dominik Roth and 15 others

PMID 38678241

WHAT IT FOUND

Twelve weeks of supervised indoor climbing improved normal and fast walking speed, stand-and-walk speed, and sit-to-stand speed in mild-to-moderate Parkinson's compared to unsupervised home exercise.

Dual-task walking did not improve in either group.

Key findings

01The climbing group increased normal walking speed by 0.09 m/s and fast walking speed by 0.1 m/s, while the control group showed no significant change.

02Climbing improved functional mobility: the Instrumented Stand and Walk Test speed increased by 0.1 m/s and the Five Times Sit to Stand test was completed 2.5 seconds faster, whereas the control group showed no significant improvement.

03Neither group improved performance during dual-task walking assessments.

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 study had a small sample size (48 participants) and was a secondary analysis of a larger trial, meaning it was not powered specifically for these gait outcomes. The control group performed unsupervised home exercise, which makes it difficult to isolate the specific effect of climbing compared to any structured physical activity. Follow-up was limited to 12 weeks, so long-term effects on gait and mobility are unknown. Participants had mild-to-moderate Parkinson's (H&Y 2–3), so results may not apply to those with more advanced disease or significant cognitive impairment. Dual-task walking did not improve in either group, and baseline dual-task interference was not observed, which limits conclusions about climbing's effect on complex mobility. The 7-meter TUG is not a validated measure, which weakens the confidence in findings from that specific test.

Declared interests

The study was funded by the Heide-Ulrich-Stiftung and a City of Vienna Scholarship. The authors declared no other conflicts of interest.

The easy way to misread this

Do not assume climbing improves dual-task walking or cognitive-motor interference. The study found no significant improvement in dual-task performance for either the climbing or control group, so this intervention should not replace targeted dual-task training for patients with that specific deficit.

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