OBJECTIVE: Evaluate immediate and long-term effects of highly challenging balance and gait training on pace-, rhythm-, variability-, asymmetry-, and postural control domains of gait for individuals with Parkinson's disease (PD). DESIGN: Randomized controlled trial -- a secondary analysis. SETTING: University hospital setting. PARTICIPANTS: One-hundred older adults with mild to moderate PD (Hoehn and Yahr 2 and 3). INTERVENTION: Training group (n = 51): 10 weeks (3 times/week) of intensive balance and gait training, incorporating dual tasks. Control group (n = 49): care as usual. MAIN OUTCOME MEASURES: Spatiotemporal gait variables collected during normal and fast walking on a pressure-sensitive mat. A linear mixed model was used to evaluate training effects post intervention and at the 6 and 12 month follow-up. RESULTS: Immediate training effects in the pace domain of gait were increased step velocity (normal speed 8.2 cm/s, p = 0.04; fast 10.8 cm/s, p < 0.01), increased step length (normal speed 3 cm, p = 0.05; fast 2.3 cm, p = 0.05) and reduced swing time variability (fast speed -2.5 ms, p = 0.02). In the rhythm domain reduced step time (fast speed -19.3 ms, p = 0.02), stance time (normal -24.3 ms, p = 0.01; fast -29.6 ms, p = 0.02) and swing time (fast speed -8.7 ms, p = 0.04) was seen. Relative to the variability domain, the training decreased step time variability (fast -2.8 ms, p = 0.02) and stance time variability (fast -3.9 ms, p = 0.02). No training effects were retained at 6 months. CONCLUSIONS: Highly challenging balance and gait training improved pace, rhythm and variability aspects of PD gait in the short-term, but effects are not retained long-term. TRIAL REGISTRATION NUMBER: NCT01417598.

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