Ding H, Droby A, Anwar AR, Hausdorff JM, Nasseroleslami B, Mirelman A, Maidan I, Muthuraman M.

Neural Regen Res. 2024 Feb;19(2):407-408. doi: 10.4103/1673-5374.377607. PMID: 37488904.

Abstract

Numerous investigations have analyzed the impact of utilizing a treadmill for walking in PD patients, and the outcomes have been encouraging. The exact mechanism through which treadmill training (TT) benefits individuals with PD is not yet fully established. One possible explanation is that the treadmill belt may serve as an external cue to modulate the pace of walking. This could potentially compensate for the impaired internal rhythm of the basal ganglia, similar to how auditory or visual cues work in PD (Herman et al., 2007). Recent studies evidenced TT as an effective method for improving gait via high-order cognitive pathways in PD patients (Droby et al., 2020). This type of training was shown to bypass the depleted dopamine pathways within the basal ganglia via the recruitment of higher-level cognitive pathways, including the cerebellum and the prefrontal cortex (Maidan et al., 2016; Droby et al., 2020), leading to improved mobility. Moreover, TT can help to increase the intensity and duration of physical activity, promoting overall fitness and reducing the risk of falls (Herman et al., 2009). Since the effects of treadmill training encompass improvements in both cognitive and motor functions, this perspective article will primarily concentrate on the enhancements in motor function and the advantages of utilizing a multimodal approach for analysis.