| Summary: | 碩士 === 國立臺灣大學 === 物理治療學研究所 === 88 === Abstract
Parkinson''s disease (PD) is a progressive and degenerative disease due to the disorder in basal ganglia. Disability in walking is a marked feature of patients with PD. Clinically, physical therapy is widely accepted as the adjunct to enhance walking ability. However, the mechanism underlying the training effect is still unclear. This study discussed some of the theoretical bases of gait training by treadmill in patients with PD. Therefore, the aim of this study included: (i) to compare the gait performance of overground and on the treadmill walking, (ii) to assess the gait performance during treadmill acceleration and deceleration, (iii) to investigate the effect of changing speed treadmill training, in patients with PD.
Eight subjects (i.e., six males and two females) with PD in Hoehn and Yahr stage II to III participated this study. The experiment included three parts. All the subjects joined the first and second parts, but only six of them finished the third part of the training program. The first part measured the gait parameters during walking in the same speed on treadmill and overground. The effects of acceleration and deceleration on treadmill were measured in the second part. Finally, subjects received the eight-week training on treadmill with changing speed. In this study, gait parameters were measured by polygraph (Gould Inc.) and recorded as: stride length, cadence, the percentage of stance phase and swing phase in a gait cycle, muscle co-contraction ratio between vastus lateralis(VL) and biceps femoris(BF), as well as muscle co-contraction ratio between gastronemius(GA) and tibialis anterior(TA). Paired t-test was used to analyze the differences of gait parameters between overground and treadmill walking and the effect of treadmill training. On-way ANOVA with repeated measurement was used to analyze the effect of treadmill acceleration and deceleration on gait parameters . P value was set as 0.05.
The main results of this study were: (i) there is no significant differences of gait parameters between overground and treadmill walking in patients with PD (ii) significant increases and decreases in stride length and normalized stride length were found when treadmill acceleration and deceleration, respectively (p=0.001) (iii) stride length, cadence, floor fastest walking speed, and percentage of swing phase in one gait cycle on floor were increased significantly (p<0.05) after eight-week treadmill training.
The conclusions were: (i) treadmill walking had similar effect as overground walking in patients with PD, (ii) patients had the ability to modify stride length during treadmill acceleration and deceleration, (iii) modification of stride length and the ability could be transfer to overground could increase after eight-week treadmill training. Therefore, treadmill can be used as the tool to assess the walking ability. Furthermore, treadmill training is effective in improving gait performance in patients with PD.
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