Supplementary Material for: The Effects of Foam Rolling after Task-oriented Circuit Training on Gait, Balance, and Range of Motion in Parkinson's Disease: A Randomized Controlled Trial

Introduction
Task-oriented circuit training (TOCT) is known to improve balance and gait in people with Parkinson's disease (PwPD). This study aimed to examine whether post-TOCT myofascial release with foam roller (FR) could extend this effect by improving gait parameters, balance performance and joint range of motion (ROM) in Parkinson’s Disease (PD).
Methods
The study was conducted in the neurological rehabilitation unit and involved 36 participants with Parkinson's disease who were randomised into intervention (IG, n = 18) and sham (SG, n = 18) groups. Both groups received TOCT for three days and eight weeks. After exercise, myofascial release was applied to the neck, trunk and lumbar region using three sets of 60-second FR in both groups. Participants' spatiotemporal gait parameters, balance, cervical, trunk and ankle dorsiflexion ROM, motor symptoms, stability limits, functional mobility, quality of life, and goal attainment level were assessed before and after the procedure.
Results
Compared with SG, gait speed, balance, stability limits, dynamic sitting balance, and trunk control improved in IG; neck, trunk, and ankle ROM increased; and motor symptom severity decreased (p < 0.05). There was no statistically significant difference in quality of life and goal attainment scores between groups (p > 0.05).
Conclusion
FR is an effective method of supporting TOCT to improve gait speed, balance, and ROM in PD. Our findings support the inclusion of myofascial release in PD rehabilitation programs.