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Improvements in temporal and postural aspects of gait vary following single- and multi-modal training in individuals with Parkinson's disease.
Parkinsonism Relat Disord. 2019 07; 64:280-285.PR

Abstract

INTRODUCTION

Gait deteriorates under dual task conditions in individuals with Parkinson's disease (PD). Therapeutic interventions have the potential to improve dual task performance, although it remains unclear how training affects gait performance under varying cognitive domains. The primary aim of this trial was to determine the effect of an 8-week single- or multi-modal gait and cognitive training intervention on dual task performance across cognitive domains in individuals with PD.

METHODS

Twenty individuals with PD completed a 24-session single-modal training (SMT, n = 10) or multi-modal training (MMT, n = 10). The SMT group performed gait and cognitive training sequentially; the MMT group performed gait and cognitive training simultaneously. Gait was analyzed using motion capture analysis during simultaneous performance of six untrained cognitive tasks.

RESULTS

Both SMT and MMT resulted in significant improvements in MDS-UPDRS III scores and gait performance. Improvements in arm swing were more prevalent in the less affected extremity, while improvements in the more affected upper extremity favored the MMT group. Temporal aspects of gait (velocity, step length) improved under all dual task conditions, while postural aspects of gait (step width, arm swing) varied by cognitive task.

CONCLUSIONS

Both SMT and MMT were effective in improving motor and dual task performance in PD. Improvements in upper extremity gait variables in the MMT group may indicate that the complexity of the training is be beneficial in PD. The different responses in temporal and postural aspects of gait highlights the need for clinicians to train multiple cognitive domains during behavioral therapy.

Authors+Show Affiliations

Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA.Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA.Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA.Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA.Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA.Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA; Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA. Electronic address: albertj@ccf.org.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31103489

Citation

Rosenfeldt, Anson B., et al. "Improvements in Temporal and Postural Aspects of Gait Vary Following Single- and Multi-modal Training in Individuals With Parkinson's Disease." Parkinsonism & Related Disorders, vol. 64, 2019, pp. 280-285.
Rosenfeldt AB, Penko AL, Streicher MC, et al. Improvements in temporal and postural aspects of gait vary following single- and multi-modal training in individuals with Parkinson's disease. Parkinsonism Relat Disord. 2019;64:280-285.
Rosenfeldt, A. B., Penko, A. L., Streicher, M. C., Zimmerman, N. M., Koop, M. M., & Alberts, J. L. (2019). Improvements in temporal and postural aspects of gait vary following single- and multi-modal training in individuals with Parkinson's disease. Parkinsonism & Related Disorders, 64, 280-285. https://doi.org/10.1016/j.parkreldis.2019.05.021
Rosenfeldt AB, et al. Improvements in Temporal and Postural Aspects of Gait Vary Following Single- and Multi-modal Training in Individuals With Parkinson's Disease. Parkinsonism Relat Disord. 2019;64:280-285. PubMed PMID: 31103489.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improvements in temporal and postural aspects of gait vary following single- and multi-modal training in individuals with Parkinson's disease. AU - Rosenfeldt,Anson B, AU - Penko,Amanda L, AU - Streicher,Matthew C, AU - Zimmerman,Nicole M, AU - Koop,Mandy Miller, AU - Alberts,Jay L, Y1 - 2019/05/14/ PY - 2019/02/01/received PY - 2019/04/30/revised PY - 2019/05/12/accepted PY - 2019/5/20/pubmed PY - 2020/5/22/medline PY - 2019/5/20/entrez KW - Cognition KW - Dual task KW - Gait KW - Parkinson's disease KW - Single task SP - 280 EP - 285 JF - Parkinsonism & related disorders JO - Parkinsonism Relat Disord VL - 64 N2 - INTRODUCTION: Gait deteriorates under dual task conditions in individuals with Parkinson's disease (PD). Therapeutic interventions have the potential to improve dual task performance, although it remains unclear how training affects gait performance under varying cognitive domains. The primary aim of this trial was to determine the effect of an 8-week single- or multi-modal gait and cognitive training intervention on dual task performance across cognitive domains in individuals with PD. METHODS: Twenty individuals with PD completed a 24-session single-modal training (SMT, n = 10) or multi-modal training (MMT, n = 10). The SMT group performed gait and cognitive training sequentially; the MMT group performed gait and cognitive training simultaneously. Gait was analyzed using motion capture analysis during simultaneous performance of six untrained cognitive tasks. RESULTS: Both SMT and MMT resulted in significant improvements in MDS-UPDRS III scores and gait performance. Improvements in arm swing were more prevalent in the less affected extremity, while improvements in the more affected upper extremity favored the MMT group. Temporal aspects of gait (velocity, step length) improved under all dual task conditions, while postural aspects of gait (step width, arm swing) varied by cognitive task. CONCLUSIONS: Both SMT and MMT were effective in improving motor and dual task performance in PD. Improvements in upper extremity gait variables in the MMT group may indicate that the complexity of the training is be beneficial in PD. The different responses in temporal and postural aspects of gait highlights the need for clinicians to train multiple cognitive domains during behavioral therapy. SN - 1873-5126 UR - https://www.unboundmedicine.com/medline/citation/31103489/Improvements_in_temporal_and_postural_aspects_of_gait_vary_following_single__and_multi_modal_training_in_individuals_with_Parkinson's_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1353-8020(19)30242-1 DB - PRIME DP - Unbound Medicine ER -