A Training Approach to Improve Stepping Automaticity While Dual-tasking in Parkinson's Disease: A Prospective Pilot Study

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2017 Feb 3

PMID 28151878

Citations 18

Authors

Taylor Chomiak

Alexander Watts

Nicole Meyer

Fernando V Pereira

Bin Hu

Affiliations

Soon will be listed here.

Abstract

Background: Deficits in motor movement automaticity in Parkinson's disease (PD), especially during multitasking, are early and consistent hallmarks of cognitive function decline, which increases fall risk and reduces quality of life. This study aimed to test the feasibility and potential efficacy of a wearable sensor-enabled technological platform designed for an in-home music-contingent stepping-in-place (SIP) training program to improve step automaticity during dual-tasking (DT).

Methods: This was a 4-week prospective intervention pilot study. The intervention uses a sensor system and algorithm that runs off the iPod Touch which calculates step height (SH) in real-time. These measurements were then used to trigger auditory (treatment group, music; control group, radio podcast) playback in real-time through wireless headphones upon maintenance of repeated large amplitude stepping. With small steps or shuffling, auditory playback stops, thus allowing participants to use anticipatory motor control to regain positive feedback. Eleven participants were recruited from an ongoing trial (Trial Number: ISRCTN06023392). Fear of falling (FES-I), general cognitive functioning (MoCA), self-reported freezing of gait (FOG-Q), and DT step automaticity were evaluated.

Results: While we found no significant effect of training on FES-I, MoCA, or FOG-Q, we did observe a significant group (music vs podcast) by training interaction in DT step automaticity (P<0.01).

Conclusion: Wearable device technology can be used to enable musically-contingent SIP training to increase motor automaticity for people living with PD. The training approach described here can be implemented at home to meet the growing demand for self-management of symptoms by patients.

Citing Articles

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Dual-Task vs. Single-Task Gait Training to Improve Spatiotemporal Gait Parameters in People with Parkinson's Disease: A Systematic Review and Meta-Analysis.

Sarasso E, Parente M, Agosta F, Filippi M, Corbetta D Brain Sci. 2024; 14(5).

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Tahmazian I, Watts A, Chen O, Ferrara H, McCrimmon A, Hu B J Neural Transm (Vienna). 2023; 130(12):1601-1607.

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Cognitive-motor dual-task interference in Alzheimer's disease, Parkinson's disease, and prodromal neurodegeneration: A scoping review.

Longhurst J, Rider J, Cummings J, John S, Poston B, Landers M Gait Posture. 2023; 105:58-74.

PMID: 37487365 PMC: 10720398. DOI: 10.1016/j.gaitpost.2023.07.277.

Effects of Music-Based Interventions on Motor and Non-Motor Symptoms in Patients with Parkinson's Disease: A Systematic Review and Meta-Analysis.

Lee H, Ko B Int J Environ Res Public Health. 2023; 20(2).

PMID: 36673802 PMC: 9859027. DOI: 10.3390/ijerph20021046.

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