<LEAP> highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions—medications, surgery, education, nutrition, exercise—and the evidence for and against the use of diagnostic tests for specific conditions. Cochrane reviews are designed to facilitate the decisions of clinicians, patients, and others in health care by providing a careful review and interpretation of research studies published in the scientific literature.1 Each article in this PTJ series summarizes a Cochrane review or other scientific evidence resource on a single topic and presents clinical scenarios based on real patients to illustrate how the results of the review can be used to directly inform clinical decisions. This article focuses on a patient with mild to moderate Parkinson disease. Can treadmill training improve the gait of individuals with Parkinson disease?
Parkinson disease (PD) affects 1 to 1.5 million people in the United States and is the second most common neurodegenerative disorder behind Alzheimer disease.2 People with PD must exhibit 2 or more of the following symptoms: rest tremor, rigidity, bradykinesia, and postural instability.3 Parkinson disease is mainly the result of the degeneration of dopaminergic neurons in the basal ganglia, specifically the substantia nigra pars compacta, and is commonly treated with levodopa, a pharmaceutical intervention.3 However, as the disease progresses, levodopa becomes less effective at managing symptoms, and additional non-dopaminergic pathways play a role in the debilitating motor symptoms of PD.3,4
People with PD often experience increased gait impairments as the disease progresses and symptoms become more severe.5 Impairments include hypokinesia (decreased step length with decreased speed), decreased coordination, …
