Virtual Reality and Body Weight-Supported Treadmill Training in Gait Rehabilitation for Parkinson Disease: A Systematic Review.

OBJECTIVE

To compare evidence on virtual reality (VR) and body weight-supported treadmill training (BWSTT) for gait rehabilitation in Parkinson's disease (PD) using a narrative review.

DESIGN

A systematic search was conducted in PubMed, PEDro, SciELO, Cochrane, and LILACS through March 2024, following PRISMA guidelines. Randomized controlled trials of VR or BWSTT in PD were included. Systematic reviews were used solely for context. Methodological quality was assessed with the PEDro and AMSTAR-2 tools.

RESULTS

Fourteen primary studies (9 VR, 5 BWSTT) with 416 participants with mild-to-moderate PD met eligibility criteria. VR protocols (5 to 12 wk) often improved balance, gait speed, and dual-task performance, but differences in immersion, platform, sensory feedback, and task complexity limited direct comparison. BWSTT interventions (4 to 8 wk, 20% to 40% unloading) showed moderate improvements in step length, walking endurance, and balance. No major adverse events were reported.

CONCLUSIONS

Both VR and BWSTT improve gait and balance in PD through complementary mechanisms. VR offers sensory-cognitive engagement, while BWSTT provides biomechanical support and repetitive practice. Due to protocol heterogeneity, small sample sizes, and the absence of meta-analysis, findings should be interpreted narratively. Combined approaches may be promising, but current evidence is limited.