Effects of motor and cognitive complex training on obstacle walking and brain activity in people with Parkinson's disease: a randomized controlled trial.
Study Goal
The researchers aimed to compare the effects of complex walking training and motor-cognitive training on obstacle walking performance and brain activity in individuals with Parkinson's disease.
Results Summary
Motor-cognitive training improved obstacle walking speed, stride length, and supplementary motor area (SMA) activity, while complex walking training showed benefits in cognitive function, mobility (TUG), and fall efficacy but not in obstacle walking or brain activation.
Population
Individuals with idiopathic Parkinson's disease.
Effective Dosage
40 minutes/session, 12 sessions over 6 weeks.
Duration
6 weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
motor-cognitive training | increase | obstacle walking speed | Individuals with idiopathic PD | - | demonstrated greater improvements in | #1 |
motor-cognitive training | increase | stride length | Individuals with idiopathic PD | - | demonstrated greater improvements in | #2 |
motor-cognitive training | increase | SMA activity | Individuals with idiopathic PD | - | demonstrated greater improvements in | #3 |
motor-cognitive training | increase | obstacle crossing velocity | Individuals with idiopathic PD | - | demonstrated greater improvements in | #4 |
motor-cognitive training | increase | digit span test | Individuals with idiopathic PD | - | demonstrated greater improvements in | #5 |
motor-cognitive training | increase | timed up and go test (TUG) | Individuals with idiopathic PD | - | demonstrated greater improvements in | #6 |
complex walking training | no change | obstacle walking | Individuals with idiopathic PD | - | did not show significant improvement in | #7 |
complex walking training | no change | brain activation | Individuals with idiopathic PD | - | did not show significant change in | #8 |
complex walking training | increase | Rey-Osterrieth Complex Figure test | Individuals with idiopathic PD | - | resulted in greater improvements in | #9 |
complex walking training | increase | timed up and go test (TUG) | Individuals with idiopathic PD | - | resulted in greater improvements in | #10 |
complex walking training | increase | fall efficacy scale (FES-I) | Individuals with idiopathic PD | - | resulted in greater improvements in | #11 |
cognitive-motor training | increase | obstacle walking performance | people with PD | - | improved | #12 |
cognitive-motor training | increase | SMA activities | people with PD | - | with increased | #13 |
BACKGROUND: The difficulties in obstacle walking are significant in people with Parkinson's disease (PD) leading to an increased fall risk. Effective interventions to improve obstacle walking with possible training-related neuroplasticity changes are needed. We developed two different exercise programs, complex walking training and motor-cognitive training, both challenging motor and cognitive function for people with PD to improve obstacle walking. AIM: To investigate the effects of these two novel training programs on obstacle walking and brain activities in PD. DESIGN: A single-center randomized, single-blind controlled study. SETTING: University laboratory; outpatient. POPULATION: Individuals with idiopathic PD. METHODS: Thirty-two participants were randomly assigned to the complex walking training group (N.=11), motor-cognitive training group (N.=11) or control group (N.=10). Participants in training groups received exercises for 40 minutes/session, with a total of 12-session over 6 weeks. Control group did not receive additional training. Primary outcomes included obstacle walking, and brain activities (prefrontal cortex (PFC), premotor cortex (PMC), and supplementary motor area (SMA)) during obstacle walking by using functional near-infrared spectroscopy. Secondary outcomes included obstacle crossing, timed up and go test (TUG), cognitive function in different domains, and fall efficacy scale (FES-I). RESULTS: The motor-cognitive training group demonstrated greater improvements in obstacle walking speed and stride length, SMA activity, obstacle crossing velocity and stride length, digit span test, and TUG than the control group. The complex walking training did not show significant improvement in obstacle walking or change in brain activation compared with control group. However, the complex walking training resulted in greater improvements in Rey-Osterrieth Complex Figure test, TUG and FES-I compared with the control group. CONCLUSIONS: Our 12-session of the cognitive-motor training improved obstacle walking performance with increased SMA activities in people with PD. However, the complex walking training did not lead such beneficial effects as the cognitive-motor training. CLINICAL REHABILITATION IMPACT: The cognitive-motor training is suggested as an effective rehabilitation program to improve obstacle walking ability in individuals with PD.