Treadmill training may be an effective form of task-specific training for improving mobility in people with Parkinson's disease and multiple sclerosis: a systematic review and meta-analysis.

BACKGROUND

Task-specific training is an effective form of rehabilitation for improving mobility in neurological conditions. However, it remains unclear if task-specific training is effective in people with progressive disease.

OBJECTIVE

To establish the efficacy of task-specific training on the mobility of individuals with progressive neurological conditions.

DATA SOURCES: Electronic databases MEDLINE, EMBASE, CINAHL and Cochrane Database of Systematic Reviews.

STUDY ELIGIBILITY CRITERIA: Randomised controlled trials investigating the effect of task-specific training on mobility and falls rate in individuals with progressive neurological conditions.

STUDY APPRAISAL/SYNTHESIS

METHODS

Risk of bias of individual studies was assessed using the Physiotherapy Evidence Database (PEDro) Scale. Mean differences (MD) and 95% confidence intervals were calculated and combined in meta-analysis.

RESULTS

Analysis of 16 trials found treadmill training improved comfortable walking velocity (m/second) in people with Parkinson's disease (MD 0.21m/second, 95%CI 0.15 to 0.27) and multiple sclerosis (MD 0.36m/second, 95%CI 0.20 to 0.52). Treadmill training improved stride length (m) (MD 0.12m, 95%CI 0.02 to 0.23) and step length (m) (MD 0.12m, 95%CI 0.01 to 0.23) in people with Parkinson's disease and walking endurance in people with multiple sclerosis (MD 26.53m, 95%CI 12.23 to 40.84). Treadmill training had no effect on cadence and did not improve walking endurance in Parkinson's disease. Over-ground walking did not improve mobility in Parkinson's disease or multiple sclerosis.

LIMITATIONS: Study sample sizes were small and findings must be interpreted with caution.

CONCLUSION

Treadmill training may be effective for improving mobility in people with Parkinson's disease and multiple sclerosis. The effectiveness of over-ground walking is uncertain.

SYSTEMATIC REVIEW PROSPERO REGISTRATION NUMBER: CRD42016047334.