Search

Background: The use of the treadmill as a gait rehabilitation tool has provided novel options for treatment of gait impairments in Parkinson's Disease (PD). However, the neural mechanisms underlying these therapeutic effects in PD remain unknown and whether any therapeutic effects from treadmill training can be reproduced on overground walking., Objective: To examine the immediate short-term effects of a single session of treadmill and overground walking on gait, spinal and corticospinal parameters in PD.METHODSPD participants (N = 15) were evaluated in two separate sessions under two walking conditions: walking over a treadmill and walking overground. Overground walking performance, the Soleus H-reflex, Reciprocal Ia-Inhibition, Intracortical Facilitation (ICF) and Short Intracortical Inhibition (SICI), were evaluated before and after each condition., Results: Gait speed and stride length improved in post-treadmill compared with pre-treadmill. No significant changes in these gait parameters were found for the pre vs. post-overground condition. ICF values and Hmax/Mmax ratio decreased after, compared with before, the two walking conditions., Conclusions: Treadmill walking, but not overground walking, lead to an improvement in the stride length and gait speed in the PD patients without evidence of different modulation on spinal and corticospinal parameters.

Objective: We tested the hypothesis that combining treadmill walking with transcranial direct current stimulation (tDCS) enhances the gait improvements associated with treadmill walking in Parkinson disease. We explored the effects of these combined methodologies on corticospinal parameters., Design: Eighteen participants with Parkinson disease were evaluated under the following three conditions: treadmill walking alone (treadmill), treadmill walking combined with anodal tDCS (AtDCS+treadmill) delivered over the motor cortex, and treadmill walking combined with sham stimulation (StDCS+treadmill). Overground walking performance, soleus H-reflex, reciprocal Ia inhibition from the tibialis anterior to the soleus muscle, intracortical facilitation, and short intracortical inhibition of the tibialis anterior muscle, were measured before and after each treadmill condition. The soleus H-reflex and walking performance on the treadmill were also evaluated., Results: All treadmill conditions improved walking performance and modulated spinal and corticospinal parameters in a similar way. However, AtDCS+treadmill lead to a different modulation of reciprocal Ia inhibition in comparison with the other treadmill conditions., Conclusions: A single session combining treadmill walking and anodal tDCS delivered over the motor cortex resulted in a specific modulation of the reciprocal Ia inhibition from the tibialis anterior to the soleus muscle. However, this acute effect did not result in improvements of gait parameters associated with treadmill walking in Parkinson disease.