Journal of Neurology

, Volume 260, Issue 1, pp 296–298 | Cite as

Long-term effect of robot-assisted treadmill walking reduces freezing of gait in Parkinson’s disease patients: a pilot study

  • Michael T. BarbeEmail author
  • Franka Cepuran
  • Martin Amarell
  • Eckhard Schoenau
  • Lars Timmermann
Letter to the Editors

Dear Sirs,

Freezing of gait (FOG) is a common and disabling symptom in patients with advanced Parkinson’s disease (PD). Treatment options are often limited, since dopaminergic medication can either alleviate or aggravate FOG, and deep brain stimulation does not seem to suppress FOG as well as other PD symptoms [5]. In the last decade, physiotherapeutic studies moved into the focus of research. Two case studies found that repetitive robot-assisted treadmill training reduces FOG [4, 10], and in a randomized controlled trial robot-assisted gait training was superior to conventional physiotherapy on general walking performance in PD patients [6]. However, long-term effects of this potentially new training method are unknown so far. Based on previous studies, we hypothesised that robot-assisted treadmill training specifically reduces FOG by either increasing step length and/or decreasing step length variation, and that, similar to other physiotherapeutic training methods, this therapeutic...


Deep Brain Stimulation Gait Analysis Gait Training Body Weight Support Step Length Variation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank the patients for study participation. Lars Timmermann is supported by the Deutsche Forschungsgemeinschaft (KFO 219; TI 319/2-1) and the German Ministry of Research and Education (BMBF).

Conflicts of interest

The authors report no conflict of interest. All authors have no affiliation and have received no financial or in kind support from the manufacturers of the equipment used in this study.

Ethical standard

All human studies must state that they have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

Supplementary material

415_2012_6703_MOESM1_ESM.xls (30 kb)
Supplementary material 1 (XLS 30 kb)


  1. 1.
    Carda S, Invernizzi M, Baricich A, Comi C, Croquelois A, Cisari C (2012) Robotic gait training is not superior to conventional treadmill training in Parkinson disease: a single-blind randomized controlled trial. Neurorehabil Neural Repair 26(9):1027–1034PubMedCrossRefGoogle Scholar
  2. 2.
    Chee R, Murphy A, Danoudis M, Georgiou-Karistianis N, Iansek R (2009) Gait freezing in Parkinson’s disease and the stride length sequence effect interaction. Brain 132:2151–2160PubMedCrossRefGoogle Scholar
  3. 3.
    Lee MS, Kim HS, Lyoo CH (2005) “Off” gait freezing and temporal discrimination threshold in patients with Parkinson disease. Neurology 64:670–674PubMedCrossRefGoogle Scholar
  4. 4.
    Lo AC, Chang VC, Gianfrancesco MA, Friedman JH, Patterson TS, Benedicto DF (2010) Reduction of freezing of gait in Parkinson’s disease by repetitive robot-assisted treadmill training: a pilot study. J Neuroeng Rehabil 7:51PubMedCrossRefGoogle Scholar
  5. 5.
    Moreau C, Defebvre L, Destee A, Bleuse S, Clement F, Blatt JL, Krystkowiak P, Devos D (2008) STN-DBS frequency effects on freezing of gait in advanced Parkinson disease. Neurology 71:80–84PubMedCrossRefGoogle Scholar
  6. 6.
    Picelli A, Melotti C, Origano F, Waldner A, Fiaschi A, Santilli V, Smania N (2012) Robot-assisted gait training in patients with Parkinson disease: a randomized controlled trial. Neurorehabil Neural Repair 26(4):353–361PubMedCrossRefGoogle Scholar
  7. 7.
    Plotnik M, Giladi N, Hausdorff JM (2008) Bilateral coordination of walking and freezing of gait in Parkinson’s disease. Eur J Neurosci 27:1999–2006PubMedCrossRefGoogle Scholar
  8. 8.
    Shine JM, Moore ST, Bolitho SJ, Morris TR, Dilda V, Naismith SL, Lewis SJ (2012) Assessing the utility of freezing of gait questionnaires in Parkinson’s disease. Parkinsonism Relat Disord 18(1):25–29PubMedCrossRefGoogle Scholar
  9. 9.
    Tan T, Almeida QJ, Rahimi F (2011) Proprioceptive deficits in Parkinson’s disease patients with freezing of gait. Neuroscience 192:746–752PubMedCrossRefGoogle Scholar
  10. 10.
    Ustinova K, Chernikova L, Bilimenko A, Telenkov A, Epstein N (2010) Effect of robotic locomotor training in an individual with Parkinson’s disease: a case report. Disabil Rehabil Assist Technol 6:77–85CrossRefGoogle Scholar
  11. 11.
    Veilleux LN, Robert M, Ballaz L, Lemay M, Rauch F (2011) Gait analysis using a force-measuring gangway: intrasession repeatability in healthy adults. J Musculoskelet Neuronal Interact 11:27–33PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Michael T. Barbe
    • 1
    • 2
    Email author
  • Franka Cepuran
    • 1
    • 3
  • Martin Amarell
    • 1
  • Eckhard Schoenau
    • 3
    • 4
  • Lars Timmermann
    • 1
  1. 1.Department of NeurologyUniversity Hospital CologneCologneGermany
  2. 2.Institute for Neuroscience and Medicine, INM-3, Forschungszentrum JülichJülichGermany
  3. 3.UniReha GmbH, Center of Prevention and RehabiliationUniversity Hospital CologneCologneGermany
  4. 4.Department of PediatricsUniversity Hospital CologneCologneGermany

Personalised recommendations