Parkinson's Disease and Cognitive-Motor Dual-Task: Is Motor Prioritization Possible in the Early Stages of the Disease?

Fernandes, Ângela; Sousa, Andreia S. P.; Rocha, Nuno; Tavares, João Manuel R. S.

doi:10.1080/00222895.2015.1105194

Cited by 6 publications

(4 citation statements)

References 37 publications

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“…Dual-task training should be part of the rehabilitation process of PD patients who have difficulty performing cognitive-motor tasks 42 , 43. Besides, patients in the initial stages of PD should perform dual-task training to prevent or delay these deficits 42.…”

Section: Discussionmentioning

confidence: 99%

“…VR optimizes the benefits of dual-task training, such as task automation and more efficient task-related network integration 30. Visuomotor training can help the reorganization and maintenance of the normal circuitry that connects the motor cortex with the basal ganglia via the thalamus or cerebellum 43. Visuomotor training can involve temporal or spatial stimuli, which regulate and facilitate repetitive movements by providing explicit targets.…”

Section: Discussionmentioning

confidence: 99%

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Is virtual reality beneficial for dual-task gait training in patients with Parkinson's disease? A systematic review

Freitag¹,

Brucki

Barbosa³

et al. 2019

Dement. neuropsychol.

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This systematic review examined the evidence about the effects of virtual reality (VR) on dual-task gait training in Parkinson's disease (PD). Methods: this study (PROSPERO registration CRD42019114736) aimed to answer the question: “Is VR beneficial for dual-task gait training in patients with PD?” We searched for studies from 2008 to 2018 on Medline/PubMed and Web of Science/Web of knowledge databases. The keywords were Parkinson AND gait training AND virtual reality OR Parkinson AND gait training AND game. A total of 55 articles were retrieved, of which 11 systematic reviews, 11 opinions, letters to the editor, posters or conferences abstracts and 17 studies not evaluating the effects of VR gait training were excluded. Three further studies addressing VR dual-task gait training in PD (found in references of studies selected) were also included. Therefore, 19 studies were included and analysed. Results: all studies reported gait improvement after VR training. Many clinical scales were used, hampering comparison of the effects of each protocol. Conclusion: VR dual-task gait training should be part of rehabilitation protocols for PD. The studies showed that VR training was effective, although specific guidelines have not yet been established.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is virtual reality beneficial for dual-task gait training in patients with Parkinson's disease? A systematic review

Freitag¹,

Brucki

Barbosa³

et al. 2019

Dement. neuropsychol.

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“…In contrast, there is growing evidence documenting the association between standing balance and gait initiation with cognition in PD population, but in a dual-tasking context (Fernandes et al, 2015, 2016). The latter have shown that some cognitive processes, such as executive functions, processing speed and semantic fluency (Smulders et al, 2013; Stegemoller et al, 2014) are associated with some gait parameters and functional mobility in PD.…”

Section: Introductionmentioning

confidence: 99%

A 12-Week Cycling Training Regimen Improves Gait and Executive Functions Concomitantly in People with Parkinson’s Disease

Nadeau

Lungu

Duchesne

et al. 2017

Front. Hum. Neurosci.

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Background: There is increasing evidence that executive functions and attention are associated with gait and balance, and that this link is especially prominent in older individuals or those who are aﬄicted by neurodegenerative diseases that affect cognition and/or motor functions. People with Parkinson’s disease (PD) often present gait disturbances, which can be reduced when PD patients engage in different types of physical exercise (PE), such as walking on a treadmill. Similarly, PE has also been found to improve executive functions in this population. Yet, no exercise intervention investigated simultaneously gait and non-motor symptoms (executive functions, motor learning) in PD patients.Objective: To assess the impact of aerobic exercise training (AET) using a stationary bicycle on a set of gait parameters (walking speed, cadence, step length, step width, single and double support time, as well as variability of step length, step width and double support time) and executive functions (cognitive inhibition and flexibility) in sedentary PD patients and healthy controls.Methods: Two groups, 19 PD patients (Hoehn and Yahr ≤2) and 20 healthy adults, matched on age and sedentary level, followed a 3-month stationary bicycle AET regimen.Results: Aerobic capacity, as well as performance of motor learning and on cognitive inhibition, increased significantly in both groups after the training regimen, but only PD patients improved their walking speed and cadence (all p < 0.05; with no change in the step length). Moreover, in PD patients, training-related improvements in aerobic capacity correlated positively with improvements in walking speed (r = 0.461, p < 0.05).Conclusion: AET using stationary bicycle can independently improve gait and cognitive inhibition in sedentary PD patients. Given that increases in walking speed were obtained through increases in cadence, with no change in step length, our findings suggest that gait improvements are specific to the type of motor activity practiced during exercise (i.e., pedaling). In contrast, the improvements seen in cognitive inhibition were, most likely, not specific to the type of training and they could be due to indirect action mechanisms (i.e., improvement of cardiovascular capacity). These results are also relevant for the development of targeted AET interventions to improve functional autonomy in PD patients.

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“…To avoid a learning effect, the order of each task changed randomly. Participants walked three consecutive loops on the walkway to minimize within-individual variability [27].…”

Section: Outcome Assessmentsmentioning

confidence: 99%

Comparison of Wuqinxi Qigong with Stretching on Single- and Dual-Task Gait, Motor Symptoms and Quality of Life in Parkinson’s Disease: A Preliminary Randomized Control Study

Shen

Song

et al. 2022

IJERPH

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The objective of this study was to investigate the therapeutic effect of Wuqinxi Qigong vs. stretching on single- and dual-task gait, motor symptoms, and quality of life in people with mild and moderate Parkinson’s disease (PD). This single-blind, randomized control trial included 40 participants with idiopathic PD who were randomized into the Wuqinxi Qigong (WQ) group or stretching group. Participants completed 12 weeks (two sessions/week) of intervention. The primary outcomes were gait parameters when performing single-task (comfortable pace) and dual-task (obstacle crossing, serial-3 subtraction and backward digit span) walking, including gait speed, stride length, and double support percentage. The secondary outcomes were ratings from the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), results of the timed-up-and-go test (TUGT), results of the Mini-Balance Evaluation Systems Test (MiniBESTest), and responses from the 39-item Parkinson’s Disease Questionnaire (PDQ-39). All measures were assessed pre- and post-intervention. The WQ group demonstrated increased gait speed (p = 0.000) during the single task, and increased stride length (p = 0.001, p = 0.021) during the single-task and serial-3 subtraction task. Double support percentage significantly decreased (p = 0.004) in the WQ group during the obstacle crossing task, and also decreased (p = 0.045) in the stretching group during the single-task. TUGT (p = 0.005), MiniBESTest (p = 0.023) and PDQ-39 (p = 0.043) in the WQ group significantly improved, and both groups showed significant improvement in MDS-UPDRS after intervention. Wuqinxi Qigong is an effective method to improve single- and dual-task gait. While both exercises improve motor symptoms, Wuqinxi Qigong results in better mobility, balance and quality of life compared to stretching alone.

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Parkinson's Disease and Cognitive-Motor Dual-Task: Is Motor Prioritization Possible in the Early Stages of the Disease?

Cited by 6 publications

References 37 publications

Is virtual reality beneficial for dual-task gait training in patients with Parkinson's disease? A systematic review

Is virtual reality beneficial for dual-task gait training in patients with Parkinson's disease? A systematic review

A 12-Week Cycling Training Regimen Improves Gait and Executive Functions Concomitantly in People with Parkinson’s Disease

Comparison of Wuqinxi Qigong with Stretching on Single- and Dual-Task Gait, Motor Symptoms and Quality of Life in Parkinson’s Disease: A Preliminary Randomized Control Study

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