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Exploring Potential Predictors of Treadmill Training Effects in People With Parkinson Disease
Si-Yu Tsai1, Chun-Hwei Tai2, Ya-Yun Lee1
1School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Objective:
To explore the potential predictors of people with Parkinson disease (PD) who would benefit the most from treadmill training.
Design:
A cohort study.
Setting:
Medical university rehabilitation settings.
Participants:
Seventy participants diagnosed of idiopathic PD.
Interventions:
Twelve sessions of treadmill training.
Main Outcome Measures:
Hierarchical logistic regression models were used to explore significant predictors of the treadmill training effect with respect to 3 health domains: Unified Parkinson's Disease Rating Scales part III (UPDRS III); gait speed; Parkinson's Disease Questionnaire-39 (PDQ-39). A receiver operating characteristic (ROC) curve analysis was conducted to identify proper cut-off points for clinical use.
Results:
Male sex (adjusted odds ratio [OR]: 3.73, P=.036) significantly predicted the improvement of UPDRS III. Individuals with a slower baseline gait speed (cut-off: 0.92 m/s, adjusted OR: 14.06, P<.001) and higher baseline balance confidence measured by the Activity-specific Balance Confidence scale (cut-off: 84.5 points, adjusted OR: 4.66, P=.022) have greater potential to achieve clinically relevant improvements in gait speed. A poorer baseline PDQ-39 score (cut-off: 23.1, adjusted OR: 7.47, P<.001) predicted a greater quality of life improvement after treadmill training.
Conclusions:
These findings provide a guideline for clinicians to easily identify suitable candidates for treadmill training. Generalization to more advanced patients with PD warrants further investigation.
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