【論文摘要】Identify Predictors for Treadmill Training: A Step Toward Individualized Care for People With Parkinson's Disease

【論文摘要】初探跑步機步態訓練效果的預測因子：邁向巴金森氏症個人化治療計畫

蔡思魚(Si-Yu Tsai) ； 林居正(Jiu-Jenq Lin) ； 李亞芸(Ya-Yun Lee)

《物理治療》 47卷4期 (2022/12) Pp. 283-284

https://doi.org/10.6215/FJPT.202212.O07

摘要

Background and Purpose: Treadmill training has been demonstrated to be one of the most effective approaches to improve walking ability in people with Parkinson's disease (PD). Nevertheless, the amount of improvement appears to vary greatly among individuals. This observation raises a critical question of what types of patient characteristics may benefit the most from treadmill training. This study aimed to explore potential characteristics of patients with PD who may demonstrate clinically relevant improvement in gait speed after treadmill training. Methods: Data from 70 participants with idiopathic PD who completed 12 sessions of treadmill training were included in this study. Using the minimal clinically important difference reported of 0.1 m/s for gait speed, participants were classified into responder or non-responder after treadmill training. Hierarchical logistic regression analysis was used to find significant predictors accounted for the treatment response of treadmill training after age and sex were adjusted. To further provide proper cut-off points for clinical use, additional receiver operating characteristic (ROC) curve analysis was then conducted. Results: The results showed that slower baseline gait speed and higher self-efficacy, as measured by the activities-specific balance confidence (ABC) scale, significantly predicted the treatment response of treadmill training. Further ROC analysis revealed that the cut-off points were 0.92 m/s for gait speed (adjusted OR = 14.06, 95% CI = 3.26- 60.51, p ＜ 0.001) and 84.5 points for ABC score (adjusted OR = 4.66, 95% CI = 1.25- 17.32, p ＜ 0.05) Conclusions: People with PD with baseline gait speed ≤ 0.92 m/s and ABC score ≥84.5 points have greater potential to achieve clinically relevant improvement of gait speed after treadmill training. Clinical Relevance: The findings of this study can help clinicians identify suitable patients for treadmill training and advance personalized care for PD rehabilitation.