Robotic-assisted gait training in Parkinson's disease: a three-month follow-up randomized clinical trial

The aim of this study was to evaluate the efficacy of a robotic-assisted gait training (RAGT), together with a conventional exercise program (CEP), to improve PD ambulation, as compared to standard gait training.

Thirty-eight patients with mild PD stage (H&Y 2-2.5) were randomly assigned to an experimental group (EG) or a control group. The 19 patients in EG received 30 min RAGT (using Lokomat device), whereas the 19 controls received a conventional gait training; both groups received 30 min of CEP. Participants were evaluated before (T0), immediately after (T1), and 12 weeks after the end of treatment (T2), by using 10-MWT, Tinetti Test and the motor score of the UPDRS-III.

We found that Tinetti Walking (TW) (X²(3) = 31.75; p < 0.001), Tinetti Balance (X²(3) = 74.07; p < 0.001), UPDRS-III (X²(3) = 6.87; p < 0.001) and GDS (X²(3) = 28.83; p < 0.001) scores were affected by the type of the rehabilitative treatment. At T2, we found a significant difference between the two groups for TW (t = 2.62; p < 0.02, d = 0.85). Concerning all the study outcomes, a significant improvement was observed from T0 to T1 in both groups. However, the functional motor gain at T2 was maintained only in the EG.

RAGT may significantly improve walking ability, motor function and for a maximum period of three months. Thus, our findings support the importance of a RAGT as a valid rehabilitative tool for PD.