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

Autor: Strouwen, C., Molenaar, E.A.L.M., Munks, L., Keus, S.H., Zijlmans, J.C., Vandenberghe, W., Bloem, B.R., Nieuwboer, A.
Rok vydání: 2017
Předmět:
Zdroj: Movement Disorders, 32, 1201-1210
Movement Disorders, 32, 8, pp. 1201-1210
ISSN: 0885-3185
Popis: Item does not contain fulltext BACKGROUND AND OBJECTIVES: Many controversies surround the usefulness of dual-task training in Parkinson's disease (PD). This study (1) compared the efficacy of two different dual-task training programs for improving dual-task gait and (2) assessed the possible fall risk of such training. METHODS: Patients (N = 121) with a diagnosis of PD (aged 65.93 [+/-9.22] years, Hoehn and Yahr stage II-III on-medication) were randomized to (1) a consecutive group in which gait and cognitive tasks were trained separately or (2) an integrated group in which gait and cognitive tasks were trained simultaneously. Both interventions involved 6 weeks of at-home physiotherapist-led training. Two baseline tests were performed as a 6-week control period before training. Posttests were performed immediately after training and at 12-week follow-up. Dual-task gait was assessed during trained and untrained secondary tasks to assess consolidation of learning. Fall risk was determined by a weekly telephone call for 24 weeks. RESULTS: No significant time by group interactions were found, suggesting that both training modes had a similar effect on dual-task gait. Immediately after training, and not after the control period, significant improvements (P < .001) in dual-task gait velocity were found in all trained and untrained dual tasks. Improvements ranged between 7.75% and 13.44% when compared with baseline values and were retained at 12-week follow-up. No significant change in fall risk occurred in both study arms (P = .84). CONCLUSIONS: 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. (c) 2017 International Parkinson and Movement Disorder Society.
Databáze: OpenAIRE
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