From Static Stability to Dynamic Gait Governance: Differential Effects of Adapted Physical Activity and Tango-Based Therapy on Walking Distance and Plantar Load Redistribution in Parkinson’s Disease

Abstract

Background: In Parkinson’s disease (PD), gait and balance impairments severely reduce patient independence. This exploratory study compared a multimodal Adapted Physical Activity (APA) protocol, a tango-based program (Riabilitango®, RT), and standard care (Control), while examining how joint constraints and plantar load distributions affect dynamic locomotor outcomes. Methods: Twenty-seven participants (Hoehn & Yahr stage 1–3) were divided into APA (n=10), RT (n=10), and Control (n=7) groups for a 3-month supervised intervention (24 sessions). Blinded assessors evaluated static balance and walking performance on a WalkerView™ treadmill at baseline (T0) and post-intervention (T1). Results: At T1, both active groups showed large effect sizes for reduced static sway versus Control, though differences were not statistically significant. Notably, the APA cohort demonstrated a substantial, significant increase in dynamic gait distance (d=2.17 vs. Control; d=1.50 vs. RT), whereas RT showed no significant walking improvements. APA also minimized the impact of joint range of motion constraints and suggested superior active postural-load regulation. Conclusions: While both interventions benefited static posture, APA was uniquely effective in improving walking distance, likely due to task-specific behavioral adaptations countering rigidity.