Versatile guideline-based physiotherapy intervention in groups to improve gait speed in Parkinson's disease patients

BACKGROUND: Gait function is known to be impaired by Parkinson's disease (PD). The effect of exercise to improve gait has been widely examined, often with special intervention. However, in clinical settings, physiotherapy rarely consists only of gait training. OBJECTIVE: To examine whether versatile physiotherapy intervention conducted in accordance with European Physiotherapy Guideline for Parkinson's Disease (EPGPD) is sufficient to increase gait speed (GS). METHODS: Participants (24) with idiopathic PD were randomly enrolled into intervention (IG) and control groups (CG) (n = 12, 7 females and 5 males in each group). Sixteen one-hour therapy sessions (twice per week) were conducted for IG. Each session focused on core areas recommended in EPGPD. Participants were assessed twice with 10 weeks between assessments. GS was calculated based on a gait test of Short Physical Performance Battery. Dominant side hip flexion and abduction range of motion (HFLEX & HABD) were measured and Freezing of Gait questionnaire (FOG) was administered. RESULTS: Versatile intervention in groups resulted in increase of GS (ES -0.9 [CI{0.1}-{0.4}] m/s) and HFLEX (ES-0.6 [CI{5.9}-{16.6 degrees}]. FOG was reduced (ES -0.41 [CI{-2.8}{-5.5}]). Re-evaluation HABD differed between groups and indicated large ES (r = -0.5). CONCLUSIONS: Versatile physiotherapy is sufficient to improve GS, range of motion and reduce FOG.