Effects of motor–cognitive training on dual-task performance in people with Parkinson’s disease: a systematic review and meta-analysis

Abstract

Motor–cognitive training in Parkinson’s disease (PD) can positively affect gait and balance, but whether motor–cognitive (dual-task) performance improves is unknown. This meta-analysis, therefore, aimed to establish the current evidence on the effects of motor–cognitive training on dual-task performance in PD. Systematic searches were conducted in five databases and 11 studies with a total of 597 people (mean age: 68.9 years; mean PD duration: 6.8 years) were included. We found a mean difference in dual-task gait speed (0.12 m/s (95% CI 0.08, 0.17)), dual-task cadence (2.91 steps/min (95% CI 0.08, 5.73)), dual-task stride length (10.12 cm (95% CI 4.86, 15.38)) and dual-task cost on gait speed (− 8.75% (95% CI − 14.57, − 2.92)) in favor of motor–cognitive training compared to controls. The GRADE analysis revealed that the findings were based on high certainty evidence. Thus, we can for the first time systematically show that people with PD can improve their dual-task ability through motor–cognitive training.

A Randomized Clinical Trial to Evaluate a Digital Therapeutic to Enhance Gait Function in Individuals With Parkinson’s Disease

“…9 Two recent reviews indicate that DTT is suitable for PwPD and is effective in improving gait function. 10,11…”

“…9 Two recent reviews indicate that DTT is suitable for PwPD and is effective in improving gait function. 10,11 Despite overwhelming support for DTT in improving gait performance for PwPD, fundamental barriers in its delivery have prevented widespread adoption (eg, time intensive and timing of DTT relative to On\Off medication periods). 12 Although >90% of surveyed rehabilitation providers reported having PD-specific training, 12 providers reported challenges with implementing DTT in PwPD.…”

Muscle Endurance, Neuromuscular Fatigability and Cognitive Control During Prolonged Dual-Task in People With Chronic Obstructive Pulmonary Disease: A Case-Control Study

“…Therefore, it seems plausible that people with impairment in neuromuscular function and cognitive processing such as pwCOPD (Dodd et al 2010; Marillier et al 2022) would experience even greater difficulties in performing prolonged CMDT. Prolonged CMDT are frequent in daily life activities and are also increasingly used for rehabilitation purposes to improve both motor and cognitive functions in a time-effective manner (Johansson et al 2023; Rozenberg et al 2023). A better understanding of the neuromuscular adaptations and cognitive control over the course of a prolonged fatiguing CMDT is thus essential before seeking to implement such interventions in the package of care of pwCOPD.…”

Effect of subthalamic coordinated reset deep brain stimulation on Parkinsonian gait

“…In this study, we tested this hypothesis by investigating the carryover effect of STN CR DBS on a modified version of the Unified Parkinson's Disease Rating Scale (mUPDRS), as well as the stride length and swing speed during gait in the Parkinsonian non-human primate (NHP) model of PD. Stride length and swing speed (similar to gait speed) are two standard gait measures (Doyle et al, 2022 ) that have been used in numerous clinical studies for differentiating PD patients from healthy controls or evaluating the effect of therapeutic treatments on gait (Luo et al, 2015 ; di Biase et al, 2020 ; De Oliveira et al, 2021 ; Gandolfi et al, 2023 ; Johansson et al, 2023 ; Matsuno et al, 2023 ). In addition, we examined the relative effect of STN CR DBS using two different burst frequencies on Parkinsonian gait.…”