Effects of augmented proprioceptive cues on the parameters of gait of individuals with Parkinson's disease.

Context : Impairment of initiating sequential movements and processing of proprioception contribute to characteristic Parkinsons disease (PD) gait abnormalities. Many studies have used a single external cue or 2 different cues to correct PD gait. Aim: An aim of this study was to determine the influence of paired proprioceptive cues on gait parameters of individuals with PD. Setting and Design: Double-blind randomized controlled trial. Materials and Methods: Subjects were 30 PD patients who had mild to moderate impairment according to the United Parkinsons Disease Rating Scale (UPDRS). They were randomly assigned to either a routine physiotherapy program or treadmill training with vibratory stimuli applied to the feet plantar surfaces and proprioceptive neuromuscular facilitation (PNF) as well as the same physiotherapy program. All Participants received a 45-minutes session of low intensity physiotherapy program, 3 times a week, for 8 weeks. The duration of treadmill training was 5 minutes at baseline and 25 minutes at the end of treatment. Walking speed and distance were recorded from the treadmill control panel for both groups before and immediately after the end of treatment. The Qualysis ProReflex motion analysis system was used to measure cadence, stride length, hip, knee, and ankle joints angular excursion. Results: The cadence, stride length, and lower limb joints angular excursion showed a significant improvement in both groups (P <= 0.05). These improvements in spatio-temporal parameters and angular excursion were higher in the study group than in the control group (P <= 0.05). Conclusion: Potentiated proprioceptive feedback improves parkinsonian gait kinematics, the hip, knee, and ankle joints angular excursion.