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Mov Disord. 2017 Aug;32(8):1201-1210. doi: 10.1002/mds.27014. Epub 2017 Apr 25.

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

Author information

1
Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation, KU Leuven, Leuven, Belgium.
2
Department of Neurology, Nijmegen Centre for Evidence Based Practice, Radboud University Medical Centre, Nijmegen, The Netherlands.
3
Department of Neurology, Amphia Hospital, Breda, The Netherlands.
4
Department of Neurology, University Hospitals Leuven, Leuven, Belgium.
5
Department of Neurosciences, KU Leuven, Leuven, Belgium.
6
Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands.

Abstract

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. © 2017 International Parkinson and Movement Disorder Society.

KEYWORDS:

Parkinson's disease; executive function; falls; gait; rehabilitation

PMID:
28440888
DOI:
10.1002/mds.27014
[Indexed for MEDLINE]

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