Trans-spinal theta burst magnetic stimulation combined with treadmill training for gait disorders in Parkinson's disease: A randomized clinical trial.

In 30 seconds

This randomized, double-blind, controlled multicenter trial tested whether intermittent theta burst trans-spinal magnetic stimulation (iTB-TsMS) added to treadmill training (TT) improves gait and related outcomes in people with Parkinson’s disease and gait disturbances. Seventy participants received 10 sessions of iTB-TsMS or sham alongside TT over 2 weeks. Compared with sham plus TT, iTB-TsMS plus TT improved fast gait speed at 3 days (adjusted mean difference 0.13 m/s; 95% CI 0.05-0.21), but this benefit was not sustained. After correction for multiple comparisons, only this result and reduced freezing-of-gait severity at 30 days remained significant.

Key findings

• Fast gait speed favored iTB-TsMS plus TT at 3 days (AMD 0.13 m/s; 95% CI 0.05-0.21; p = 0.001), with no sustained difference.
• Freezing-of-gait questionnaire scores favored iTB-TsMS plus TT at 30 days (AMD -2.30; 95% CI -3.77 to -0.83; p = 0.002); this remained significant after multiple-comparison correction.
• Other between-group differences, including near-falls and motor or quality-of-life measures, did not remain significant after correction for multiple comparisons.
• The protocol was reported as safe and well tolerated.

Why it matters

Gait impairment and freezing can substantially affect mobility and daily function in Parkinson’s disease. This trial suggests that adding iTB-TsMS to treadmill training may yield short-term gains in gait speed and a later reduction in freezing severity, but the lack of sustained gait-speed benefit and the limited corrected findings mean the overall added benefit remains uncertain.

What to keep in mind

Follow-up extended to 90 days, and the authors describe the findings as hypothesis-generating. Most reported outcome differences did not remain significant after correction for multiple comparisons.