Body Weight Support Gait Training for Patients With Parkinson Disease: A Systematic Review and Meta-analyses

Objective: To determine the effectiveness of body weight support (BWS) gait training to improve the clinical severity, gait, and balance in patients with Parkinson disease (PD). Data Sources: A literature search was conducted until July 2020 in MEDLINE, Physiotherapy Evidence Database, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature. Study Selection: Randomized controlled trials that aimed at determining the effectiveness of physical activity interventions with BWS during gait training in patients with PD. Data Extraction: The methodological quality of randomized controlled trials was assessed using the Cochrane risk of bias tool (RoB 2.0). Effect size (ES) and 95% confidence intervals [CIs] were calculated for the Unified Parkinson Disease Rating Scale (UPDRS), the UPDRS section III, the 6-minute walk test (6MWT), gait parameters (ie, velocity, cadence, stride length), and the Berg Balance Scale (BBS). Data Synthesis: Twelve studies were included in the systematic review. The pooled ES for the effect of BWS on total UPDRS was-0.35 (95% CI,-0.57 to-0.12; I-2=1.9%, P=.418), whereas for UPDRS III it was-0.35 (95% CI,-0.68 to-0.01; I-2=66.4 %, P<.001). Furthermore, the pooled ES for 6MWT was 0.56 (95% CI,-0.07 to 1.18; I-2=77.1%, P=.002), for gait velocity was 0.37 (95% CI,-0.10 to 0.84); I-2=78.9%, P<.001), for cadence was 0.03 (95% CI,-0.25 to 0.30; I-2=0.0%, P=.930), for stride length was 1.00 (95% CI, 0.23 to 1.78; I-2=79.5%, P=.001), and for BBS was 0.65 (95% CI, 0.30, 0.99; I-2=51.8%, P=.042). Conclusions: Interventions with BWS could improve the general and motor clinical severity of patients with PD, as well as other parameters such as stride length and balance. However, the effect does not appear to be statistically significant in improving gait parameters such as velocity, cadence, and distance. Archives of Physical Medicine and Rehabilitation 2021;102:2012-21 (c) 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.