Training dual tasks together or apart in Parkinson's disease: Results from the DUALITY trial

Strouwen, Carolien; Molenaar, Esther; Münks, Liesbeth; Keus, S.H.J.; Zijlmans, J.C.M.; Vandenberghe, Wim; Bloem, Bastiaan R.; Nieuwboer, Alice

doi:10.1002/mds.27014

Cited by 122 publications

(146 citation statements)

References 34 publications

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“…Although this does not exclude a left‐DLPFC involvement during dual‐task gait in the FOG‐ group, this suggests that left DLPFC is more involved in gait worsening under dual task in the FoG + group, thus making this area more susceptible to tDCS modulation. Our findings expand those by Dagan and colleagues, suggesting that noninvasive brain stimulation could represent an adjunctive method to integrated or consecutive dual‐task training to treat FOG.…”

supporting

confidence: 86%

Anodal tDCS over prefrontal cortex improves dual‐task walking in Parkinsonian patients with freezing

Putzolu

Pelosin²,

Ogliastro³

et al. 2018

Movement Disorders

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supporting

confidence: 86%

Anodal tDCS over prefrontal cortex improves dual‐task walking in Parkinsonian patients with freezing

Putzolu

Pelosin²,

Ogliastro³

et al. 2018

Movement Disorders

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“…A recent meta-analysis showed that dual tasking have detrimental effects on gait speed in people with PD [42]. Several studies have shown that dual task training improves dual task performance in people with PD Parkinson's Disease 5 [43][44][45]; those that seem to benefit the most are those with a slow gait speed (while dual tasking) but with a good cognitive functioning [46]. A highly challenging balance intervention that included dual task training, however, detected any shortterm effects neither on gait performance during dual tasking nor on concerns about falling [47].…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors of Concerns about Falling in People with Parkinson’s Disease: A 3-Year Longitudinal Study

Lindh-Rengifo

Jonasson

Mattsson

et al. 2019

Parkinson's Disease

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Introduction. Fear of falling (FOF) is more common in people with Parkinson's disease (PD) than in healthy controls. It can lead to several negative consequences such as restrictions in everyday life. Moreover, FOF is a risk factor for future falls. Aim. is study aimed to identify predictive factors of FOF (conceptualized as concerns about falling) after three years, with and without adjusting for concerns about falling at baseline, in people with PD. Methods. is study included 151 participants (35% women) with PD. At baseline, their mean (SD) age and PD duration were 68 (±9.0) and 9 (±6.1) years, respectively. e Falls Efficacy Scale-International (FES-I) was used as the dependent variable in multivariable linear regression analyses. Results. e mean (SD) FES-I score increased from 28.1 (11.9) to 33.1 (14.0) three years later (p < 0.001). e strongest (according to the standardized regression coefficient, β) predictor of concerns about falling was walking difficulties (β � 0.378), followed by age (0.227), problems maintaining balance while dual tasking (0.172), and needing help in daily activities (0.171). When adjusting for baseline FES-I scores, the strongest predictive factor was problems maintaining balance while dual tasking (β � 0.161), which was followed by age (0.131) and female sex (0.105). Conclusions. is study pinpoints several predictive factors of concerns about falling that are modifiable and which could be addressed in rehabilitation: perceived walking difficulties, having problems maintaining balance while dual tasking, and dependence on others in daily activities. e importance of dual tasking is a novel finding, which future studies need to confirm or refute. One should be aware of the fact that an increased age predicts concerns about falling with and without adjusting for baseline FES-I scores, whereas female sex predicts concerns about falling only when adjusting for baseline FES-I scores.

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“…Because these axial symptoms only improve partially with dopaminergic medication [2,[5][6][7][8], non-pharmacological interventions such as physiotherapy are important to manage these problems [9][10][11][12]. There is growing evidence that physiotherapy interventions improve gait [13][14][15][16][17][18][19] and balance performance in PD [20][21][22][23][24][25][26][27][28]. Physiotherapy typically involves functional gait and balance exercises [9,10,24] that translate directly to daily life activities [29][30][31].…”

Section: Introductionmentioning

confidence: 99%

Multimodal Balance Training Supported by Rhythmical Auditory Stimuli in Parkinson’s Disease: A Randomized Clinical Trial

Capato

Vries²,

IntHout³

et al. 2020

JPD

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Background: Balance impairment in Parkinson's disease (PD) improves only partially with dopaminergic medication. Therefore, non-pharmacological interventions such as physiotherapy are important elements in clinical management. External cues are often applied to improve gait, but their effects on balance control are unclear. Objective/Methods: We performed a prospective, single-blind, randomized clinical trial to study the effectiveness of balance training with and without rhythmical auditory cues. We screened 201 volunteers by telephone; 154 were assigned randomly into three groups: (1) multimodal balance training supported by rhythmical auditory stimuli (n = 56) (RAS-supported multimodal balance training); (2) regular multimodal balance training without rhythmical auditory stimuli (n = 50); and (3) control intervention involving a general education program (n = 48). Training was performed for 5 weeks, two times/week. Linear mixed models were used for all outcomes. Primary outcome was the Mini-BESTest (MBEST) score immediately after the training period. Assessments were performed by a single, blinded assessor at baseline, immediately post intervention, and after one and 6-months follow-up. Results: Immediately post intervention, RAS-supported multimodal balance training was more effective than regular multimodal balance training on MBEST (difference 3.5 (95% Confidence Interval (CI) 2.2; 4.8)), p < 0.001). Patients allocated to both active interventions improved compared to controls (MBEST estimated mean difference versus controls 6.6 (CI 5.2; 8.0), p < 0.001 for RAS-supported multimodal balance training; and 3.0 (CI 2.7; 5.3), p < 0.001 for regular multimodal balance training). Improvements were retained at one-month follow-up for both active interventions, but only the RAS-supported multimodal balance training group maintained its improvement at 6 months. Conclusion: Both RAS-supported multimodal balance training and regular multimodal balance training improve balance, but RAS-supported multimodal balance training-adding rhythmical auditory cues to regular multimodal balance traininghas greater and more sustained effects.

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Training dual tasks together or apart in Parkinson's disease: Results from the DUALITY trial

Abstract: Consecutive and integrated dual-task training led to similar and sustained improvements in dual-task gait velocity without increasing fall risk. These novel findings support adoption of dual-task training in clinical practice. © 2017 International Parkinson and Movement Disorder Society.

Cited by 122 publications

References 34 publications

Anodal tDCS over prefrontal cortex improves dual‐task walking in Parkinsonian patients with freezing

Anodal tDCS over prefrontal cortex improves dual‐task walking in Parkinsonian patients with freezing

Predictive Factors of Concerns about Falling in People with Parkinson’s Disease: A 3-Year Longitudinal Study

Multimodal Balance Training Supported by Rhythmical Auditory Stimuli in Parkinson’s Disease: A Randomized Clinical Trial

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