Postural Stability and Cognitive Performance of Subjects With Parkinson’s Disease During a Dual-Task in an Upright Stance

Morenilla, Luis; Márquez, Gonzalo; Sánchez, José Andrés; Bello, Olalla; López-Alonso, Virginia; Fernández‐Lago, Helena; Fernández-del-Olmo, Miguel

doi:10.3389/fpsyg.2020.01256

Cited by 15 publications

(18 citation statements)

References 70 publications

(99 reference statements)

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“…This is also demonstrated by the higher level of activation of the prefrontal cortex during walking with increasing age (83). Previous studies also reported higher cognitive DTC in PD (43,84) and stroke patients (4) compared with healthy participants. This has been linked to physical and cognitive impairment related to these disorders and to reduced attention and cognitive reserve (85).…”

Section: E Ect Of Age and Disease Groupmentioning

confidence: 59%

Cognitive dual-task cost depends on the complexity of the cognitive task, but not on age and disease

Bianchini

Warmerdam²,

Romijnders³

et al. 2022

Front. Neurol.

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IntroductionDual-tasking (DT) while walking is common in daily life and can affect both gait and cognitive performance depending on age, attention prioritization, task complexity and medical condition. The aim of the present study was to investigate the effects of DT on cognitive DT cost (DTC) (i) in a dataset including participants of different age groups, with different neurological disorders and chronic low-back pain (cLBP) (ii) at different levels of cognitive task complexity, and (iii) in the context of a setting relevant to daily life, such as combined straight walking and turning.Materials and methodsNinety-one participants including healthy younger and older participants and patients with Parkinson's disease, Multiple Sclerosis, Stroke and cLBP performed a simple reaction time (SRT) task and three numerical Stroop tasks under the conditions congruent (StC), neutral (StN) and incongruent (StI). The tasks were performed both standing (single task, ST) and walking (DT), and DTC was calculated. Mixed ANOVAs were used to determine the effect of group and task complexity on cognitive DTC.ResultsA longer response time in DT than in ST was observed during SRT. However, the response time was shorter in DT during StI. DTC decreased with increasing complexity of the cognitive task. There was no significant effect of age and group on cognitive DTC.ConclusionOur results suggest that regardless of age and disease group, simple cognitive tasks show the largest and most stable cognitive effects during DT. This may be relevant to the design of future observational studies, clinical trials and for clinical routine.

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Section: E Ect Of Age and Disease Groupmentioning

confidence: 59%

Cognitive dual-task cost depends on the complexity of the cognitive task, but not on age and disease

Bianchini

Warmerdam²,

Romijnders³

et al. 2022

Front. Neurol.

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“…In addition, Matinolli et al (2007) demonstrated that individuals with PD who are fallers had higher postural sway and CoP displacement compared to PD non-fallers and healthy controls. Other studies demonstrated increased CoP displacement with visual deprivation and additional cognitive load in individuals with PD ( Marchese et al, 2003 ; Holmes et al, 2010 ; Morenilla et al, 2020 ). In the present study, Figure 2 demonstrated increased CoP displacement in PD fallers with visual occlusion; however, the effect of additional cognitive load was absent measured by CoP displacement.…”

Section: Discussionmentioning

confidence: 83%

Pupillary Response to Postural Demand in Parkinson’s Disease

Kahya¹,

Lyons²,

Pahwa³

et al. 2021

Front. Bioeng. Biotechnol.

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Background: Individuals with Parkinson’s disease (PD) may need to spend more mental and physical effort (i.e., cognitive workload) to maintain postural control. Pupillary response reflects cognitive workload during postural control tasks in healthy controls but has not been investigated as a measure of postural demand in PD.Objectives: To compare pupillary response during increased postural demand using vision occlusion and dual tasking between individuals with PD and healthy controls.Methods: Thirty-three individuals with PD and thirty-five healthy controls were recruited. The four conditions lasted 60 s and involved single balance task with eyes open; single balance task with eyes occluded; dual task with eyes open; dual task with eyes occluded. The dual task comprised the Auditory Stroop test. Pupillary response was recorded using an eye tracker. The balance was assessed by using a force plate. Two-way Repeated Measures ANOVA and LSD post-hoc tests were employed to compare pupillary response and Center of Pressure (CoP) displacement across the four conditions and between individuals with PD and healthy controls.Results: Pupillary response was higher in individuals with PD compared to healthy controls (p = 0.009) and increased with more challenging postural conditions in both groups (p < 0.001). The post-hoc analysis demonstrated increased pupillary response in the single balance eyes occluded (p < 0.001), dual task eyes open (p = 0.01), and dual task eyes occluded (p < 0.001) conditions compared to single task eyes open condition.Conclusion: Overall, the PD group had increased pupillary response with increased postural demand compared to the healthy controls. In the future, pupillary response can be a potential tool to understand the neurophysiological underpinnings of falls risk in the PD population.

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“…Each dynamic test will be registered two times. As a result, the primary outcome of the study will be the CoP sway area, which is defined as the surface over which the CoP moves during the measurement and is a valid indicator of detecting postural control changes in dual-task conditions ( Campolettano et al, 2020 ; Morenilla et al, 2020 ). The secondary outcomes are shown in Table 2 and consist of biomechanics and clinical variables related to static and dynamic balance.…”

Section: Materials and Analysismentioning

confidence: 99%

Functional balance training in people with Parkinson’s disease: a protocol of balanceHOME randomized control trial with crossover

Guinot

Valenzuela

Asensi³

et al. 2023

Front. Aging Neurosci.

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IntroductionBalance disturbances in Parkinson’s Disease (PD) are usually assessed in a single-task as well as standard balance physiotherapy is carried out in isolated environments. Conversely, daily activities are developed in highly challenging environments. Although functional balance training (FBT) is included in the latest protocols, several methodological issues have not yet been considered. In the proposed single-blinded randomized control trial with crossover (NCT04963894), the aims are (1) to quantify the effects achieved by domiciliary FBT (balanceHOME program) in participants with and without cognitive impairment, and (2) to compare them with the effects of a passive-control period and a conventional face-to-face physiotherapy program for PD.MethodsThe initial recruitment was estimated at 112 people with idiopathic PD. Two-thirds of the participants will be randomized to one of the two groups to make the crossover. In contrast, the other third will do a face-to-face group program only. The balanceHOME protocol consists of challenging balance exercises incorporated into functional daily tasks, developed in-home and conducted two times per week for 60-min over an 8-weeks period. The primary strategy will consist of splitting functional tasks of daily life into static and dynamic balance components, besides standardized facilitate and disturbing strategies to execution of each exercise. Biomechanics and clinical performance of balance and gait, perception of quality of life, cognitive and mental functioning, and severity of PD will be measured at baseline (T0), post-8 weeks training (T1), and follow-up (T2).ResultsThe primary outcome of the study will be the center of pressure sway area. The secondary outcomes consist of biomechanics and clinical variables related to static and dynamic balance. Outcomes from biomechanical of gait, quality of life, cognitive and mental state, and severity of PD, represent the tertiary outcomes.DiscussionThe balanceHOME program standardizes the FBT in demanding and daily environments for people with PD who prefer individualized treatment from home. This is the first time that the effects of group versus individual balance rehabilitation have been compared in people with and without cognitive impairment and evaluated in complex environments. This still-to-be-finished study will open the possibility of new strategies according to changes in post-pandemic therapeutic approaches.

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Postural Stability and Cognitive Performance of Subjects With Parkinson’s Disease During a Dual-Task in an Upright Stance

Cited by 15 publications

References 70 publications

Cognitive dual-task cost depends on the complexity of the cognitive task, but not on age and disease

Cognitive dual-task cost depends on the complexity of the cognitive task, but not on age and disease

Pupillary Response to Postural Demand in Parkinson’s Disease

Functional balance training in people with Parkinson’s disease: a protocol of balanceHOME randomized control trial with crossover

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