Combining automated mechanical peripheral stimulation and treadmill exercise for gait rehabilitation in Parkinson's disease: A randomized controlled trial

BACKGROUND: <AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Treadmill exercise improves step length and velocity in Parkinson's disease (PD) but may not fully address all critical elements of gait, such as double support, which is closely associated with fall risk. Treadmill exercise combined with additional non-pharmacological strategies has the potential to yield a more comprehensive therapeutic approach. The application of automated mechanical peripheral stimulation (AMPS) has been identified as a potential intervention for gait rehabilitation, demonstrating efficacy in enhancing walking speed in PD. In principle, pre-activating sensory pathways via AMPS could prime the motor system for enhanced engagement during treadmill training. This study aimed to investigate the acute effects of AMPS combined with treadmill exercise in individuals with PD.</AbstractText> METHODS: <AbstractText Label="METHODS" NlmCategory="METHODS">This randomized controlled trial involved fifteen individuals with PD (69.6 ± 5.1 years, MoCA: 27.3 ± 3.6 pts.</AbstractText> , UDPRS: <AbstractText Label=", UDPRS" NlmCategory="UNASSIGNED">31.0 ± 6.9 pts.</AbstractText> , H&Y: <AbstractText Label=", H&Y" NlmCategory="UNASSIGNED">1-3). Each participant visited the lab four times: once for clinical assessment and three times to undergo intervention conditions - AMPS, Exercise, and AMPS+Exercise - in a randomized order. A seven-day washout period was implemented between each intervention session. Gait assessment was conducted before and after each intervention.</AbstractText> FINDINGS: <AbstractText Label="FINDINGS" NlmCategory="RESULTS">Repeated measure ANOVA revealed a main effect of time for step length and step velocity (both p < 0.05), with higher values post-intervention. After statistically controlling for baseline in step velocity, the Exercise showed greater adjusted post-intervention value than AMPS+Exercise condition (p = 0.031).</AbstractText> INTERPRETATION: <AbstractText Label="INTERPRETATION" NlmCategory="CONCLUSIONS">Although AMPS has emerged as a non-pharmacological technique to improve gait spatiotemporal parameters in individuals with PD, its combination with treadmill exercise did not yield superior effects in this acute protocol.</AbstractText>