Repetitive step training with preparatory signals improves stability limits in patients with Parkinson's disease.

OBJECTIVE To examine the effects of repetitive volitional and compensatory step training with preparatory signals on the limits of stability, postural and gait skills, and spatiotemporal gait characteristics in patients with Parkinson's disease with no falls during the previous 12 months. DESIGN Randomized clinical trial with assessor blinded to group assignment. SUBJECTS Twenty-eight patients with Parkinson's disease with no falls during the previous 12 months. METHODS Eligible patients were randomly assigned to an experimental group, which undertook repetitive step training with preparatory visual cues, or a control group, which undertook lower limb strength training for 4 weeks. Outcome measures included limits of stability test, postural and gait sub-scores from Unified Parkinson's Disease Rating Scale motor score (UPDRS-PG), and spatiotemporal gait characteristics. All tests were conducted before and after training at patients' peak medication cycle. RESULTS The experimental group showed significant improvements in reaction time, movement velocity, and endpoint excursion of limits of stability, as well as UPDRS-PG score and stride length (p < 0.05), compared with the control group. Both groups significantly increased gait velocity (p < 0.05). CONCLUSION Repetitive step training with preparatory cues can enhance limits of stability, postural and gait skills and spatiotemporal gait characteristics in patients with Parkinson's disease with no falls during the previous 12 months.