Dual task and postural control in Alzheimer's and Parkinson's disease

Abstract

Patients with neurodegenerative diseases are required to use cognitive resources while maintaining postural control. The aim of this study was to investigate the effects of a frontal cognitive task on postural control in patients with Alzheimer, Parkinson and controls. Thirty-eight participants were instructed to stand upright on a force platform in two experimental conditions: single and dual task. Participants with Parkinson's disease presented an increase in the coefficient of variation greater than 100% in the dual task as compared to the single task for center of pressure (COP) area and COP path. In addition, patients with Parkinson's and Alzheimer's disease had a higher number of errors during the execution of the cognitive task when compared to the group of elderly without neurodegenerative diseases. The motor cortex, which is engaged in postural control, does not seem to compete with frontal brain regions in the performance of the cognitive task. However, patients with Parkinson's and Alzheimer's disease presented worsened performance in cognitive task.Resumo-"Tarefa dupla e controle da postura na doença de Alzheimer e na doença de Parkinson". Pacientes com doenças neurodegenerativas utilizam recursos cognitivos para manutenção do controle postural. O objetivo deste estudo foi investigar os efeitos de uma tarefa cognitiva frontal no controle postural em pacientes com Alzheimer, com Parkinson e idosos sem doenças neurodegenerativas. Trinta e oito participantes foram instruídos a ficar em pé sobre uma plataforma de força em duas condições experimentais: tarefa simples e tarefa dupla com uma tarefa cognitiva frontal. Foi observado aumento no coeficiente de variação superior a 100% na área e na trajetória do centro de pressão (COP) em condição de tarefa dupla em pacientes com Parkinson. Foi observada também, diferença significativa na comparação entre grupos, mostrando que pacientes com Parkinson e Alzheimer tiveram maior número de erros durante a execução da tarefa cognitiva, quando comparado ao grupo de idosos sem doenças neurodegenerativas. O córtex motor envolvido na manutenção do controle postural parece não competir com regiões frontais cerebrais no desempenho desse tipo de tarefa cognitiva, no entanto, os pacientes com doença de Parkinson e doença de Alzheimer apresentaram pior desempenho durante a execução de uma tarefa cognitiva frontal.Palavras-chave: controle da postura, tarefa dupla, doença de Alzheimer, doença de Parkinson Resumen-"Doble tarea y el control postural en la enfermedad de Alzheimer y la enfermedad de Parkinson". Pacientes con enfermedades neurodegenerativas utilizan de recursos cognitivos para el mantenimiento del control postural. El objetivo de este estudio fue investigar los efectos de una tarea cognitiva frontal en el control postural de pacientes con enfermedad de Alzheimer, enfermedad de Parkinson y ancianos sin enfermedades neurodegenerativas. Treinta y ocho participantes fueron instruidos para mantenerse en pie sobre una plataforma de fuerza en dos condiciones experimentales:...

Effects of dual tasks and dual-task training on postural stability: a systematic review and meta-analysis

“…Of the included studies, 33 studies incorporated mixed-gender participant groups 16–18,20–22,36,61–67,69–78,81–84,87,88,90–94. Four studies incorporated only female participants,35,79,85,86 and two studies incorporated only male participants 34,89.…”

“…The average PEDro score for the 42 included studies was computed to be 4.7 out of 10, indicating fair quality of the overall studies. One study scored 7,36 three studies scored 6,21,35,65 20 studies scored 5,16,17,20,34,69–72,74,77,79–84,86,92–95 and 18 studies scored 4 22,48,61–63,66–68,73,75,76,78,81,85,87–89,91…”

“…However, the third study despite having similar variables could not be included as the descriptive statistics were not available in the text and were not obtained even after contacting the corresponding author. Similarly, three other studies analyzing patients affected by Parkinson’s disease could not be included due to lack of descriptive statistics 22,92,93. Only one study analyzed the effects of dual tasks on postural stability of participants affected from degenerative cerebellar disorder 91…”

“…Significant enhancements in postural stability were reported in one good65 and one fair-quality study 94. Additionally, five fair-quality studies reported a significant reduction in postural stability among individuals affected by Parkinson’s disease,22,93,94 multiple sclerosis,66 and degenerative cerebellar disorder 91. One good-quality study reported a reduction in postural stability (not significant) among participants affected by Parkinson’s disease 92.…”

“…Eight studies evaluating the effects of dual-task performance on postural stability among participants affected by neurological disorders, such as cerebellar disorder, Parkinson’s disease,22,92–94 and multiple sclerosis,21,65,66,91 were included in the review. Significant enhancements in postural stability were reported in one good65 and one fair-quality study 94.…”