Multicomponent and mat Pilates training increased gait speed in individuals with Parkinson's disease when walking and carrying a load: A single-blinded randomized controlled trial

Background and Purpose: Gait disorders in individuals with Parkinson's disease (IwPD) are among the most disabling symptoms. Physical exercise has been proposed for the treatment of IwPD because it shows positive effects on gait variables. Given the importance of physical activity in the rehabilitation process of IwPD, the assessment of interventions to identify those most promising for improving or maintaining gait performance is of great relevance. Therefore, this study evaluated the effects of Mat Pilates Training (MPT) and Multicomponent Training (MCT) on the spatiotemporal variables of gait in situations of daily dual-task performance in IwPD. Gait analysis in a daily dual-task context allows the simulation of real-life conditions where individuals have a higher risk of falling than in single-task walking. Methods: We conducted a single-blinded randomized controlled trial with 34 mild-to-moderate IwPD (Hoehn-Yahr stage 1-2). They were randomized to one of two interventions: MPT or MCT. All participants performed the training for 60 min, three times per week, for 20 weeks. Spatiotemporal gait variables were evaluated in a daily life situation to increase the ecological validity of the measurements, which included gait speed, stride time, double support time, swing time, and cadence. The individuals walked on a platform holding two bags with a load corresponding to 10% of their body mass. Results: After the intervention, there was a significant improvement in gait speed in both groups: MPT (p = 0.047) and MCT (p = 0.015). The MPT group reduced the cadence (p = 0.005) and the MCT group increased the stride length (p = 0.026) after the intervention. Discussion: Both groups had positive effects on gait speed with load transport resulting from the two proposed interventions. However, the MPT group showed a spatiotemporal adjustment of speed and cadence that can increase gait stability, which was not found in the MCT group.