{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T19:19:47Z","timestamp":1793387987156,"version":"4.5.0"},"reference-count":45,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: Parkinson\u2019s disease (PD) is a neurodegenerative disorder that impairs mobility. Treadmill training (TT) is a common rehabilitation strategy for improving gait parameters in individuals with PD. This systematic review evaluated the effectiveness of TT in improving motor function, walking ability, and overall functional mobility in PD patients. Methods: We compared TT to other forms of gait and motor rehabilitation, including conventional and robotic gait training. Trials that compared a treadmill training group with a non-intervention group were excluded from this review. We searched multiple databases for RCTs involving Parkinson\u2019s patients until January 2025. The primary outcomes were motor function (UPDRS-III) and walking ability (6 MWT and TUG test). Results: We identified 285 articles; 199 were excluded after screening. We assessed the full text of 86 articles for eligibility, and 13 RCTs met the inclusion criteria. Some of them were included in the meta-analysis. The TT group showed a significant improvement in UPDRS-III scores [mean difference (MD): \u22121.36 (95% CI: \u22122.60 to \u22120.11)] and greater improvement in TUG performance [MD, \u22121.75 (95% CI: \u22122.69 to \u22120.81)]. No significant difference in walking capacity as assessed through the 6 MWT was observed [MD: 26.03 (95% CI: \u22126.72 to 58.77). Conclusions: The current study suggests that TT is effective in improving the motor symptoms and functional mobility associated with PD. Further studies are needed to develop protocols that consider the patients\u2019 clinical characteristics, disease stage, exercise tolerance, and respiratory function.<\/jats:p>","DOI":"10.3390\/brainsci15080788","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T14:11:44Z","timestamp":1753366304000},"page":"788","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Treadmill Training in Patients with Parkinson\u2019s Disease: A Systematic Review and Meta-Analysis on Rehabilitation Outcomes"],"prefix":"10.3390","volume":"15","author":[{"given":"Elisa","family":"Boccali","sequence":"first","affiliation":[{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation of the Institute of Lumezzane, 25065 Lumezzane, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2238-7499","authenticated-orcid":false,"given":"Carla","family":"Simonelli","sequence":"additional","affiliation":[{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Cardiac Rehabilitation of the Institute of Lumezzane, 25065 Lumezzane, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Salvi","sequence":"additional","affiliation":[{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, 25065 Lumezzane, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3982-2098","authenticated-orcid":false,"given":"Mara","family":"Paneroni","sequence":"additional","affiliation":[{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, 25065 Lumezzane, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9389-7915","authenticated-orcid":false,"given":"Michele","family":"Vitacca","sequence":"additional","affiliation":[{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, 25065 Lumezzane, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5261-3595","authenticated-orcid":false,"given":"Davide Antonio","family":"Di Pietro","sequence":"additional","affiliation":[{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Cardiac Rehabilitation of the Institute of Lumezzane, 25065 Lumezzane, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S1474-4422(05)70285-4","article-title":"The diagnosis of Parkinson\u2019s disease","volume":"5","author":"Tolosa","year":"2006","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/S1474-4422(16)30230-7","article-title":"The epidemiology of Parkinson\u2019s disease: Risk factors and prevention","volume":"15","author":"Ascherio","year":"2016","journal-title":"Lancet Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1880","DOI":"10.1016\/j.apmr.2009.06.017","article-title":"Gait analysis in patients with Parkinson\u2019s disease off dopaminergic therapy","volume":"90","author":"Zwick","year":"2009","journal-title":"Arch Phys. Med. Rehabil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/0022-510X(90)90184-O","article-title":"Quantitative analysis of gait in Parkinson patients: Increased variability of stride length","volume":"98","author":"Blin","year":"1990","journal-title":"J. Neurol. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1093\/brain\/117.5.1169","article-title":"The pathogenesis of gait hypokinesia in Parkinson\u2019s disease","volume":"117","author":"Morris","year":"1994","journal-title":"Brain"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"eRW5233","DOI":"10.31744\/einstein_journal\/2020RW5233","article-title":"Effects of treadmill training on gait of elders with Parkinson\u2019s disease: A literature review","volume":"18","author":"Luna","year":"2020","journal-title":"Einstein"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1177\/1545968320952799","article-title":"Physiotherapy in Parkinson\u2019s Disease: A Meta-Analysis of Present Treatment Modalities","volume":"34","author":"Radder","year":"2020","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_8","first-page":"CD013856","article-title":"Physical exercise for people with Parkinson\u2019s disease: A systematic review and network meta-analysis","volume":"1","author":"Ernst","year":"2023","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_9","first-page":"CD007830","article-title":"Treadmill training for patients with Parkinson\u2019s disease","volume":"2015","author":"Mehrholz","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/S1474-4422(16)00116-2","article-title":"The new definition and diagnostic criteria of Parkinson\u2019s disease","volume":"15","author":"Postuma","year":"2016","journal-title":"Lancet Neurol."},{"key":"ref_11","first-page":"499","article-title":"The European Physiotherapy Guideline for Parkinson\u2019s Disease: Implications for Neurologists","volume":"8","author":"Domingos","year":"2018","journal-title":"J. Park. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"(2003). The Unified Parkinson\u2019s Disease Rating Scale (UPDRS): Status and recommendations. Mov. Disord., 18, 738\u2013750.","DOI":"10.1002\/mds.10473"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"(2002). ATS statement: Guidelines for the six-minute walk test. Am. J. Respir. Crit. Care Med., 166, 111\u2013117.","DOI":"10.1164\/ajrccm.166.1.at1102"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","article-title":"The timed \u201cUp & Go\u201d: A test of basic functional mobility for frail elderly persons","volume":"39","author":"Podsiadlo","year":"1991","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1002\/mds.27242","article-title":"Validation study of the Hoehn and Yahr scale included in the MDS-UPDRS","volume":"33","author":"Skorvanek","year":"2018","journal-title":"Mov. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_17","unstructured":"R Core Team (2015). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing. Available online: http:\/\/www.R-project.org."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"101","DOI":"10.2307\/3001666","article-title":"The combination of estimates from different experiments","volume":"10","author":"Cochrane","year":"1954","journal-title":"Biometrics"},{"key":"ref_19","unstructured":"Bland, M. (2019). Statistica Medica, Apogeo Education. [2nd ed.]."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"Laird","year":"1986","journal-title":"Control. Clin. Trials"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1016\/j.parkreldis.2015.10.006","article-title":"Minimal clinically important difference on the Motor Examination part of MDS-UPDRS","volume":"21","author":"Aschermann","year":"2015","journal-title":"Park. Relat. Disord."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/jep.12629","article-title":"Minimal clinically important difference for change in 6-minute walk test distance of adults with pathology: A systematic review","volume":"23","author":"Bohannon","year":"2017","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"114","DOI":"10.2522\/ptj.20090126","article-title":"Minimal detectable change of the timed \u201dup & go\u201d test and the dynamic gait index in people with Parkinson disease","volume":"91","author":"Huang","year":"2011","journal-title":"Phys. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1016\/j.apmr.2015.05.007","article-title":"Partial Body Weight-Supported Treadmill Training in Patients with Parkinson Disease: Impact on Gait and Clinical Manifestation","volume":"96","author":"Ganesan","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"183","DOI":"10.2147\/CIA.S68779","article-title":"Comparison of strength training, aerobic training, and additional physical therapy as supplementary treatments for Parkinson\u2019s disease: Pilot study","volume":"10","author":"Carvalho","year":"2015","journal-title":"Clin. Interv. Aging"},{"key":"ref_26","first-page":"557","article-title":"The effects of speed-dependent treadmill training and rhythmic auditory-cued overground walking on gait function and fall risk in individuals with idiopathic Parkinson\u2019s disease: A randomized controlled trial","volume":"34","author":"Harro","year":"2014","journal-title":"NeuroRehabilitation"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1001\/jamaneurol.2013.646","article-title":"Randomized clinical trial of 3 types of physical exercise for patients with Parkinson disease","volume":"70","author":"Shulman","year":"2013","journal-title":"JAMA Neurol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.parkreldis.2017.06.021","article-title":"Effects of curved-walking training on curved-walking performance and freezing of gait in individuals with Parkinson\u2019s disease: A randomized controlled trial","volume":"43","author":"Cheng","year":"2017","journal-title":"Park. Relat. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1249\/MSS.0000000000000144","article-title":"Effects of 24 wk of treadmill training on gait performance in Parkinson\u2019s disease","volume":"46","author":"Nadeau","year":"2014","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.parkreldis.2013.02.010","article-title":"Robot-assisted gait training versus equal intensity treadmill training in patients with mild to moderate Parkinson\u2019s disease: A randomized controlled trial","volume":"19","author":"Picelli","year":"2013","journal-title":"Park. Relat. Disord."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.rehab.2019.06.016","article-title":"Clinical effects of robot-assisted gait training and treadmill training for Parkinson\u2019s disease. A randomized controlled trial","volume":"62","author":"Capecci","year":"2019","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/NPT.0000000000000245","article-title":"Exercise and Parkinson Disease: Comparing Tango, Treadmill, and Stretching","volume":"43","author":"Rawson","year":"2019","journal-title":"J. Neurol. Phys. Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1016\/j.gaitpost.2013.02.005","article-title":"The effects of treadmill or overground walking training programme on gait in Parkinson\u2019s disease","volume":"38","author":"Bello","year":"2013","journal-title":"Gait Posture"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1177\/1545968312446753","article-title":"Robotic gait training is not superior to conventional treadmill training in parkinson disease: A single-blind randomized controlled trial","volume":"26","author":"Carda","year":"2012","journal-title":"Neurorehabil. Neural Repair."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"101620","DOI":"10.1016\/j.rehab.2021.101620","article-title":"Robot-assisted gait training with auditory and visual cues in Parkinson\u2019s disease: A randomized controlled trial","volume":"65","author":"Kim","year":"2022","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1053\/apmr.2002.34603","article-title":"Long-term effect of body weight-supported treadmill training in Parkinson\u2019s disease: A randomized controlled trial","volume":"83","author":"Miyai","year":"2002","journal-title":"Arch Phys. Med. Rehabil."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1093\/ptj\/80.6.578","article-title":"Movement disorders in people with Parkinson disease: A model for physical therapy","volume":"80","author":"Morris","year":"2000","journal-title":"Phys. Ther."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1212\/01.wnl.0000313835.33830.80","article-title":"Determinants of disability and quality of life in mild to moderate Parkinson\u2019s disease","volume":"70","author":"Muslimovic","year":"2008","journal-title":"Neurology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.1007\/s13760-022-02147-0","article-title":"The effects of augmented and virtual reality gait training on balance and gait in patients with Parkinson\u2019s disease","volume":"123","author":"Gulcan","year":"2023","journal-title":"Acta Neurol. Belg."},{"key":"ref_40","first-page":"1140","article-title":"Physical Therapy for Freezing of Gait and Gait Impairments in Parkinson Disease: A Systematic Review","volume":"12","author":"Rutz","year":"2020","journal-title":"Phys. Med. Rehabil."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Kojima, G., Masud, T., Kendrick, D., Morris, R., Gawler, S., Treml, J., and Iliffe, S. (2015). Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial. BMC Geriatr., 15.","DOI":"10.1186\/s12877-015-0039-7"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3199","DOI":"10.1080\/09638288.2022.2120099","article-title":"The effect of rehabilitation interventions on freezing of gait in people with Parkinson\u2019s disease is unclear: A systematic review and meta-analyses","volume":"45","author":"Goh","year":"2023","journal-title":"Disabil. Rehabil."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Vitacca, M., Olivares, A., Comini, L., Vezzadini, G., Langella, A., Luisa, A., Petrolati, A., Frigo, G., and Paneroni, M. (2021). Exercise Intolerance and Oxygen Desaturation in Patients with Parkinson\u2019s Disease: Triggers for Respiratory Rehabilitation?. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182312298"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Matos, L.M., de Araujo, O.F.M., Barbosa Roca, R.S., Pimentel, A.D.S., Neves, L.M.T., Crisp, A.H., Peyr\u00e9-Tartaruga, L.A., Correale, L., Coertjens, M., and Passos-Monteiro, E. (2025). Can walking capacity predict respiratory functions of people with Parkinson\u2019s disease?. Front. Neurol., 16.","DOI":"10.3389\/fneur.2025.1531571"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1016\/j.neubiorev.2021.10.019","article-title":"The effects of treadmill exercise in animal models of Parkinson\u2019s disease: A systematic review","volume":"131","author":"Ferreira","year":"2021","journal-title":"Neurosci. Biobehav. Rev."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/15\/8\/788\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:15:30Z","timestamp":1760033730000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/15\/8\/788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,24]]},"references-count":45,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["brainsci15080788"],"URL":"https:\/\/doi.org\/10.3390\/brainsci15080788","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,24]]}}}