{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T19:09:21Z","timestamp":1772046561793,"version":"3.50.1"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["RRC-2025-23686388"],"award-info":[{"award-number":["RRC-2025-23686388"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Freezing of Gait (FoG) is a debilitating motor symptom affecting nearly half of individuals with Parkinson\u2019s disease (PD), increasing fall risk and reducing independence. Despite pharmacological and neuromodulation therapies, residual symptoms often persist, underscoring the need for complementary rehabilitation strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effects of body weight\u2013supported treadmill training using differential air pressure on gait and mobility in PD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty patients with idiopathic PD were randomly assigned to an experimental group (EG, n\u2009=\u200920), who received gait training with a lower-body positive pressure treadmill, or to a control group (CG, n\u2009=\u200920), who underwent conventional physiotherapy. Both groups trained twice weekly for 4 months. Outcomes were assessed at baseline (T0) and post-intervention (T1), and classified as primary (gait speed, step length, balance, postural stability) or secondary (quality of life, fear of falling, anxiety).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to controls, the EG showed significant improvements in gait speed, step length, balance, and postural stability (all p\u2009&lt;\u20090.01). Secondary outcomes also improved, with reductions in fear of falling (p\u2009&lt;\u20090.01) and better quality of life scores (p\u2009&lt;\u20090.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This pilot trial suggests that body weight\u2013supported treadmill training through differential air pressure may improve gait performance and postural control, while also enhancing quality of life in PD patients with mobility impairments and FoG. These preliminary findings support its potential role as a complementary rehabilitation strategy, warranting confirmation in larger trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0341021","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T18:23:11Z","timestamp":1772043791000},"page":"e0341021","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhancing gait training with anti-gravity treadmill \u2018Alter-G\u2019 in patients with Parkinson\u2019s disease"],"prefix":"10.1371","volume":"21","author":[{"given":"Desire\u00e8","family":"Latella","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonino","family":"Lombardo Facciale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirjam","family":"Bonanno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lilla","family":"Bonanno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonino","family":"Leo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Cellini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Di Lorenzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piero","family":"Buonasera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7591-3080","authenticated-orcid":true,"given":"Caterina","family":"Formica","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Paladina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Pergolizzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bartolo","family":"Fonti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Quartarone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rocco Salvatore","family":"Calabr\u00f2","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"issue":"1","key":"pone.0341021.ref001","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/ene.14108","article-title":"Parkinson disease","volume":"27","author":"R Balestrino","year":"2020","journal-title":"Eur J Neurol"},{"issue":"4","key":"pone.0341021.ref002","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1136\/jnnp.2007.131045","article-title":"Parkinson\u2019s disease: clinical features and diagnosis","volume":"79","author":"J Jankovic","year":"2008","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"4","key":"pone.0341021.ref003","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/j.ncl.2016.06.012","article-title":"Epidemiology of Parkinson Disease","volume":"34","author":"A Lee","year":"2016","journal-title":"Neurol Clin"},{"key":"pone.0341021.ref004","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.parkreldis.2017.10.013","article-title":"A prospective study of falls in relation to freezing of gait and response fluctuations in Parkinson\u2019s disease","volume":"46","author":"Y Okuma","year":"2018","journal-title":"Parkinsonism Relat Disord"},{"issue":"4","key":"pone.0341021.ref005","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1046\/j.1468-1331.2003.00611.x","article-title":"Characterization of freezing of gait subtypes and the response of each to levodopa in Parkinson\u2019s disease","volume":"10","author":"JD Schaafsma","year":"2003","journal-title":"Eur J Neurol"},{"key":"pone.0341021.ref006","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1038\/s41531-018-0052-6","article-title":"Cognitive training for freezing of gait in Parkinson\u2019s disease: a randomized controlled trial","volume":"4","author":"CC Walton","year":"2018","journal-title":"NPJ Parkinsons Dis"},{"issue":"1","key":"pone.0341021.ref007","article-title":"Freezing of gait in Parkinson\u2019s disease: pathophysiology, risk factors and treatments","volume":"9","author":"C Gao","year":"2020","journal-title":"Transl Neurodegener"},{"issue":"8","key":"pone.0341021.ref008","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/S1474-4422(11)70143-0","article-title":"Freezing of gait: moving forward on a mysterious clinical phenomenon","volume":"10","author":"JG Nutt","year":"2011","journal-title":"The Lancet Neurology"},{"issue":"1","key":"pone.0341021.ref009","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1186\/s12984-024-01449-z","article-title":"Simulating space walking: a systematic review on anti-gravity technology in neurorehabilitation","volume":"21","author":"M Bonanno","year":"2024","journal-title":"J Neuroeng Rehabil"},{"issue":"1","key":"pone.0341021.ref010","doi-asserted-by":"crossref","first-page":"323","DOI":"10.3390\/app12010323","article-title":"Lower-body positive pressure treadmill training for pediatric gait disorders: a scoping review","volume":"12","author":"Y Cherni","year":"2021","journal-title":"Applied Sciences"},{"issue":"10","key":"pone.0341021.ref011","doi-asserted-by":"crossref","first-page":"739","DOI":"10.3390\/brainsci10100739","article-title":"Anti-gravity treadmill training for freezing of gait in parkinson\u2019s disease","volume":"10","author":"JF Baizabal-Carvallo","year":"2020","journal-title":"Brain Sci"},{"key":"pone.0341021.ref012","doi-asserted-by":"crossref","first-page":"1401256","DOI":"10.3389\/fneur.2024.1401256","article-title":"Research progress on the application of anti-gravity treadmill in the rehabilitation of Parkinson\u2019s disease patients: a mini review","volume":"15","author":"Y Zheng","year":"2024","journal-title":"Front Neurol"},{"issue":"8","key":"pone.0341021.ref013","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.3390\/biomedicines11082148","article-title":"Do patients with parkinson\u2019s disease benefit from dynamic body weight support? A Pilot study on the emerging role of rysen","volume":"11","author":"L Ciatto","year":"2023","journal-title":"Biomedicines"},{"key":"pone.0341021.ref014","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jare.2019.09.005","article-title":"Walking on the Moon: A randomized clinical trial on the role of lower body positive pressure treadmill training in post-stroke gait impairment","volume":"21","author":"RS Calabr\u00f2","year":"2019","journal-title":"J Adv Res"},{"issue":"4","key":"pone.0341021.ref015","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.apmr.2004.11.005","article-title":"Validating the Berg Balance Scale for patients with Parkinson\u2019s disease: A key to rehabilitation evaluation","volume":"86","author":"AA Qutubuddin","year":"2005","journal-title":"Archives of Physical Medicine and Rehabilitation"},{"issue":"1","key":"pone.0341021.ref016","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s11845-022-02954-7","article-title":"Determinants of 6-minute walk test in people with Parkinson\u2019s disease","volume":"192","author":"BO \u00dc\u011f\u00fct","year":"2023","journal-title":"Ir J Med Sci"},{"issue":"10","key":"pone.0341021.ref017","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1007\/s12603-011-0062-0","article-title":"Timed up and go test and risk of falls in older adults: a systematic review","volume":"15","author":"O Beauchet","year":"2011","journal-title":"J Nutr Health Aging"},{"issue":"4","key":"pone.0341021.ref018","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1519\/JPT.0000000000000068","article-title":"Test-retest reliability and minimal detectable change for the 10-meter walk test in older adults with Parkinson\u2019s disease","volume":"39","author":"JT Lang","year":"2016","journal-title":"J Geriatr Phys Ther"},{"issue":"9234","key":"pone.0341021.ref019","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1016\/S0140-6736(00)02695-7","article-title":"Screening older adults at risk of falling with the Tinetti balance scale","volume":"356","author":"M Ra\u00eeche","year":"2000","journal-title":"The Lancet"},{"issue":"1","key":"pone.0341021.ref020","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.jphys.2013.12.014","article-title":"Fall Efficacy Scale-International (FES-I)","volume":"60","author":"N Dewan","year":"2014","journal-title":"J Physiother"},{"key":"pone.0341021.ref021","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1186\/1471-2474-14-249","article-title":"Reliability of spatiotemporal and kinetic gait parameters determined by a new instrumented treadmill system","volume":"14","author":"LF Reed","year":"2013","journal-title":"BMC Musculoskelet Disord"},{"key":"pone.0341021.ref022","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.jelekin.2018.06.009","article-title":"Gait evaluation using inertial measurement units in subjects with Parkinson\u2019s disease","volume":"42","author":"M Zago","year":"2018","journal-title":"J Electromyogr Kinesiol"},{"issue":"4","key":"pone.0341021.ref023","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0266140","article-title":"Measuring quality of life with the Parkinson\u2019s disease questionnaire-39 in people with cognitive impairment","volume":"17","author":"A Sch\u00f6nenberg","year":"2022","journal-title":"PLoS One"},{"issue":"3","key":"pone.0341021.ref024","first-page":"155","article-title":"EuroQol-5D (EQ-5D): an instrument for measuring quality of life","volume":"78","author":"G Balestroni","year":"2012","journal-title":"Monaldi Arch Chest Dis"},{"issue":"4","key":"pone.0341021.ref025","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1590\/S0004-282X2010000400005","article-title":"Generalized anxiety disorder and the hamilton anxiety rating scale in Parkinson\u2019s disease","volume":"68","author":"A Kummer","year":"2010","journal-title":"Arq Neuro-Psiquiatr"},{"issue":"1","key":"pone.0341021.ref026","doi-asserted-by":"crossref","first-page":"135","DOI":"10.3233\/JPD-230117","article-title":"Delivering multidisciplinary rehabilitation care in parkinson\u2019s disease: an international consensus statement","volume":"14","author":"JG Goldman","year":"2024","journal-title":"Journal of Parkinson\u2019s Disease"},{"issue":"3","key":"pone.0341021.ref027","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jphys.2021.06.004","article-title":"Physiotherapy management of Parkinson\u2019s disease","volume":"67","author":"MY Pang","year":"2021","journal-title":"J Physiother"},{"issue":"6","key":"pone.0341021.ref028","article-title":"Physiotherapy for Parkinson\u2019s disease: a comparison of techniques","volume":"2014","author":"CL Tomlinson","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"pone.0341021.ref029","doi-asserted-by":"crossref","first-page":"587","DOI":"10.4103\/1673-5374.293151","article-title":"Anxiety, depression, and quality of life in Parkinson\u2019s disease: the implications of multidisciplinary treatment","volume":"16","author":"F Corallo","year":"2021","journal-title":"Neural Regen Res"},{"key":"pone.0341021.ref030","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1017\/S1368980099000567","article-title":"The influence of physical activity on mental well-being","volume":"2","author":"KR Fox","year":"1999","journal-title":"Public Health Nutr"},{"issue":"1658","key":"pone.0341021.ref031","doi-asserted-by":"crossref","first-page":"20130402","DOI":"10.1098\/rstb.2013.0402","article-title":"Auditory rhythmic cueing in movement rehabilitation: findings and possible mechanisms","volume":"369","author":"RS Schaefer","year":"2014","journal-title":"Philos Trans R Soc Lond B Biol Sci"},{"issue":"2","key":"pone.0341021.ref032","article-title":"Effects of virtual reality-based multimodal audio-tactile cueing in patients with spatial attention deficits: pilot usability study","volume":"10","author":"SEJ Knobel","year":"2022","journal-title":"JMIR Serious Games"},{"issue":"7","key":"pone.0341021.ref033","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1109\/TNSRE.2020.2998123","article-title":"Observing actions through immersive virtual reality enhances motor imagery training","volume":"28","author":"JW Choi","year":"2020","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"issue":"9","key":"pone.0341021.ref034","article-title":"Effectiveness of the aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in healthy community-dwelling older adults: A systematic review and meta-analysis","volume":"18","author":"RS Melo","year":"2023","journal-title":"PLoS ONE"},{"key":"pone.0341021.ref035","first-page":"191","article-title":"Treadmill training improves overground walking economy in Parkinson\u2019s disease: a randomized, controlled pilot study","volume":"5","author":"MA Fern\u00e1ndez-Del-Olmo","year":"2014","journal-title":"Front Neurol"},{"key":"pone.0341021.ref036","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1007\/978-3-031-74123-4_24","article-title":"Split-belt treadmill to treat gait disorders.","author":"C Schlenstedt","year":"2024","journal-title":"Locomotion and Posture in Older Adults. Springer Nature Switzerland"},{"issue":"3","key":"pone.0341021.ref037","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1097\/NPT.0000000000000093","article-title":"A randomized controlled feasibility trial of a specific cueing program for falls management in persons with parkinson disease and freezing of gait","volume":"39","author":"T Martin","year":"2015","journal-title":"J Neurol Phys Ther"},{"issue":"2","key":"pone.0341021.ref038","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1093\/ptj\/81.2.810","article-title":"Reliability of measurements obtained with the Timed \u201cUp & Go\u201d test in people with Parkinson disease","volume":"81","author":"S Morris","year":"2001","journal-title":"Phys Ther"},{"issue":"4","key":"pone.0341021.ref039","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.3390\/jcm13041105","article-title":"Effectiveness of Body Weight-Supported Gait Training on Gait and Balance for Motor-Incomplete Spinal Cord Injuries: A Systematic Review with Meta-Analysis","volume":"13","author":"R Arroyo-Fern\u00e1ndez","year":"2024","journal-title":"J Clin Med"},{"key":"pone.0341021.ref040","doi-asserted-by":"crossref","DOI":"10.3389\/fbioe.2025.1541240","article-title":"Beyond clinical scales: an observational study on instrumental gait analysis and biomechanical patterns in patients with Parkinson\u2019s disease","volume":"13","author":"P De Pasquale","year":"2025","journal-title":"Front Bioeng Biotechnol"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0341021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T18:23:18Z","timestamp":1772043798000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0341021"}},"subtitle":[],"editor":[{"given":"Giovanni","family":"Mostile","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0341021","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]}}}