Effects of curved-walking training on curved-walking performance and freezing of gait in individuals with Parkinson's disease: A randomized controlled trial

The purpose of this study was to investigate the effects of curved-walking training (CWT) on curved-walking performance and freezing of gait (FOG) in people with Parkinson's disease (PD).Twenty-four PD subjects were recruited and randomly assigned to the CWT group or control exercise (CE) group and received 12 sessions of either CWT with a turning-based treadmill or general exercise training for 30 min followed by 10 min of over-ground walking in each session for 4-6 weeks. The primary outcomes included curved-walking performance and FOG. All measurements were assessed at baseline, after training, and at 1-month follow-up.Our results showed significant improvements in curved-walking performance (speed, p = 0.007; cadence, p = 0.003; step length, p < 0.001) and FOG, measured by a FOG questionnaire (p = 0.004). The secondary outcomes including straight-walking performance (speed, cadence and step length, p < 0.001), timed up and go test (p = 0.014), functional gait assessment (p < 0.001), Unified Parkinson's disease Rating Scale III (p = 0.001), and quality of life (p < 0.001) were also improved in the experimental group. We further noted that the improvements were maintained for at least one month after training (p < 0.05).A 12-session CWT program can improve curved-walking ability, FOG, and other measures of functional walking performance in individuals with PD. Most of the improvements were sustained for at least one month after training.