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

Gait and balance impairments in Parkinson's disease (PD) severely compromise mobility and independence. This exploratory randomized pilot study evaluated a multimodal Adapted Physical Activity (APA) protocol, a tango-based program (Riabilitango®, RT), and standard care regarding walking distance, static postural stability, joint range of motion, and plantar-load redistribution. Twenty-seven participants with PD (Hoehn and Yahr 1-3) were allocated to APA (n = 10), RT (n = 10), or Control (n = 7). The active groups completed 24 supervised sessions over 12 weeks. Static postural stability and treadmill-based walking distance were evaluated at baseline and post-intervention. Both active interventions showed favorable static sway profiles compared to Control, though between-group differences were non-significant. Crucially, APA demonstrated a significantly greater post-intervention improvement in walking distance than RT and Control. Exploratory analyses linked APA walking gains to adaptations in joint mobility and plantar-load redistribution. In conclusion, multimodal APA showed the clearest functional signal for improving walking distance in PD, whereas Riabilitango® offered a complementary profile focused on sensorimotor integration and balance. These preliminary pilot findings warrant confirmation in larger prospective trials.