Cognitive and motor dual task gait training exerted specific training effects on dual task gait performance in individuals with Parkinson’s disease: A randomized controlled pilot study

Abstract

Gait impairments in Parkinson’s disease (PD) are aggravated under dual task conditions. Providing effective training to enhance different dual task gait performance is important for PD rehabilitation. This pilot study aimed to investigate the effects of cognitive and motor dual task gait training on dual task gait performance in PD. Eighteen PD participants (n = 6 per training group) were assigned to cognitive dual task gait training (CDTT), motor dual task gait training (MDTT), or general gait training (control) group randomly. The training was 30 min each session, 3 sessions per week for 4 weeks. Primary outcomes including gait performance during cognitive dual task, motor dual task, and single walking were assessed at pre- and post-training. The results showed decreased double support time during cognitive dual task walking after CDTT (-17.1±10.3%) was significantly more than MDTT (6.3±25.6%, p = .006) and control training (-5.6±7.8%, p = .041). Stride time variability during motor dual task walking decreased more after MDTT (-16.3±32.3%) than CDTT (38.6±24.0%, p = .015) and control training (36.8±36.4%, p = .041). CDTT also improved motor dual task walking performance especially on gait speed (13.8±10.71%, p = .046) stride length (10.5±6.6%, p = .046), and double support time (-8.0±2.0%, p = .028). CDTT improved single walking performance as well on gait speed (11.4±5.5%, p = .046), stride length (9.2±4.6%, p = .028), and double support time (-8.1±3.0%, p = .028). In summary, our preliminary data showed 12-session of CDTT decreased double support time during cognitive dual task walking, and MDTT reduced gait variability during motor dual task walking. Different training strategy can be adopted for possibly different training effects in people with PD.

Dual-task training on gait, motor symptoms, and balance in patients with Parkinson’s disease: a systematic review and meta-analysis

“…However, we found no significant changes in step or stride lengths at post-intervention, possibly due to a lack of customization of the training modalities for improving these gait parameters. The small sample sizes in some studies, [21][22][23]27,28 heterogeneity of the dual-task paradigm, and differences in assessment criteria may have further affected the generalization of our present results. Nevertheless, a significant increase in stride length was observed in two non-RCTs; these studies conducted a single 30-minutes session or three 30-minutes sessions, and training effects were maintained at followups.…”

“…Cadence results were reported in six RCTs, from a total number of 145 participants in the dual-task training groups. The meta-analysis based on random effects revealed a significant improvement in cadence (SMD, −0.25; 95% CI, −0.48 to −0.02; P = 0.03; I 2 , 0% 18,[21][22][23]26,28 ; Figure 2). There was no significant heterogeneity tested among these studies.…”

“…All patients included in the RCTs were on a stable medication regimen. [18][19][20][21][22][23][24][25][26][27][28] With the exception of one study, all other studies involved assessments at the 'on' status of medications. 29 As shown in Table 1, the interventions in the experimental group involved two different types of tasks, whereas the control group either performed one type of approach or maintained regular activities.…”

Effect of Dual Task Training on Balance and Functional Mobility in Children with Cerebral Palsy

“…Automatiniais judesiais laikoma pirminė užduotis -ėjimas, bėgimas, lipimas laiptais ir pan. Pridėjus antrinę motorinę užduotį, iš pradžių gali sutrikti minėti automatiniai judesiai, tačiau po kurio laiko jie patobulėja, sumažėja klaidų skaičius, dėl to pagerėja žmogaus motorinės funkcijos (Plummer et al, 2016;Yang et al, 2019).…”

The use of Motor and Cognitive Dual-Task quantitative assessment on subjects with mild cognitive impairment: A systematic review

“…Interestingly, the adoption of this approach went beyond the early detection of Alzheimer's Disease (AD) and dementia. The quantitative motor assessment has been applied on studies on healthy adults [Sunderaraman et al (2019)], lower limb amputee people [Petrini et al (2019)], presence of peripheral neuropathy in diabetics patients [Paul et al (2009)], stroke patients [Curuk et al (2019)], subject with Parkinson's Disease (PD) [Yang et al (2019)], and even on children with intellectual disability [Kachouri et al (2019)].…”