Speed-Variable Treadmill Training Improves Hand Motor Function in Individuals With Parkinson's Disease

Aerobic exercise programs with proprioceptive sensory feedback elements such as split-belt treadmill training, perturbation treadmill training, and dynamic cycling improve function in people with Parkinson's disease (PwPD). However, these tools are expensive and not highly accessible. Speed-variable (SV) treadmill training utilizes small-amplitude treadmill belt speed fluctuations every 10-60 s, emulating aforementioned paradigms in a more-accessible design targeted toward home or gym settings. Fourteen PwPD (67.6 ± 6.5 years, 6 female) completed one 30-min session of SV training and one 30-min session of normal (N) non-speed-varied treadmill training in a counterbalanced design. Motor function was assessed pre- and postexercise with KinesiaONE inertial measurement unit validated for assessment of symptoms including tremor, bradykinesia, rhythm, and amplitude of movement. Heart rate (HR) did not differ significantly (p = 0.146, t = -1.102) across conditions, with average HR in 60%-65% age-predicted HRmax range. Rating of perceived exertion (RPE) was significantly (p = 0.020, t = 2.274, effect size 0.608) lower in SV condition than N condition by 0.8 points on the 6-20 Borg scale. Generalized linear mixed model analysis revealed significant interaction effects in sum hand motor function, bradykinesia and tremor sum, and resting and postural tremor items (p < 0.05), driven by improvements in symptoms post-SV exercise. No significant interactions were observed for hand amplitude, rhythm of movement, or lower body symptoms. Overall, data support SV treadmill training as an exercise paradigm for PwPD to acutely impact hand motor function utilizing a standard treadmill. Future work should evaluate multiple sessions of training and evaluate dose-response effect of speed variability.