Almeida 2012.
Methods | Parallel group design. Randomised by pulling allocation out of a hat. Analysed on a per protocol basis. Treated as outpatients for 9 hours over 6 weeks. Assessed at baseline, 6 weeks, and 12 weeks. Assessors were blinded for UPDRS III evaluation. |
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Participants | 14 participants in the Overground walking group (OG), 14 in the Treadmill walking group (TM), and 14 in the control group (CL). 2 dropouts in TM group, 1 dropout in CL group. Participants' mean age 73.9 years (OG), 63.9 years (TM), and 67.4 years (CL); male/female 12/2 (OG), 8/6 (TM), and 11/3 (CL); Hoehn and Yahr stage not stated; duration of PD not stated. Inclusion criteria: confirmed as having clinically typical Parkinson's disease by at least one movement disorders neurologist. Exclusion criteria: past history of neurological conditions other than Parkinson's disease, orthopaedic or visual disturbances that severely impaired walking ability, unable to independently walk down an 8‐meter GAITRite carpet for a total of 10 trials. |
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Interventions | OG: walk down equally spaced transverse lines presented on a 16‐m carpet. The cues were white lines of tape. Participants asked to walk across the lines, turn, and continue back. Spacings were set at 8% greater than the initial step length of any of the groups (70 cm). 30‐Minute session with mandatory 2‐minute break every 8 minutes, additional rest allowed if necessary, but a total of 24 minutes of walking was required for a gait session to be considered complete. TM: Walk on a treadmill presented with equally distributed standardised transverse white lines. Spacings were set at 8% greater than the initial step length of any of the groups (70 cm). 30‐minute session with mandatory 2‐minute break every 8 minutes, additional rest allowed if necessary, but a total of 24 minutes of walking was required for this gait session to be considered complete. CL: instructed to continue their usual activities. Participants were optimally medicated at time of all training and testing sessions and remained on stable regimen throughout trial period. |
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Outcomes | Step length. UPDRS III. Timed up and go. Gait speed. Cadence. Double support time. Step time. Step‐to‐step variability, Step time variability. 30‐Ssecond chair stand. |
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Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Eligibility Criteria | Low risk | Eligibility criteria stated. |
Randomisation Method | High risk | Allocation pulled out of hat. |
Concealment of Allocation | High risk | Allocation pulled out of hat. |
Similarity at Baseline | Low risk | |
Withdrawals Described | Low risk | Withdrawals at less than 10%. |
Intention To Treat Analysis | High risk | Analysed on a per protocol basis. |
Cointerventions Constant | Low risk | Participants maintained stable drug regiment throughout trial period. |
Blinded Assessors | Low risk | Assessors blind for UPDRS III evaluation only. (This is the only subjective outcome.) |