The efficacy of cognitive-cycling dual-task training in patients with early-stage Parkinson’s disease: A pilot study

Abstract

BACKGROUND: Recent studies have suggested that cognitive-motor dual-task (DT) training might improve gait performance, locomotion automaticity, balance, and cognition in patients with Parkinson’s disease (PD). OBJECTIVE: We aimed to investigate the efficacy of cognitive-cycling DT training in patients with early-stage PD. METHODS: Participants were scheduled to perform cognitive tasks simultaneously with the cycling training twice per week for eight weeks for a total of 16 sessions during their on-states. Clinical assessments were conducted using the unified Parkinson’s disease rating scale (UPDRS), modified Hoehn and Yahr stage, Timed Up and Go (TUG) test, gait and cognitive performances under dual-task paradigm, the new freezing of gait questionnaire, Schwab and England Activities of Daily Living scale, 39-item Parkinson’s disease questionnaire, and cognitive performance. RESULTS: Thirteen eligible patients were enrolled in the study. The mean age was 60.64±5.32 years, and the mean disease duration was 7.02±3.23 years. Twelve PD patients completed 16 serial cognitive-cycling sessions for two months. After 16 sessions of training (T2), the UPDRS III scores improved significantly in both the off- and on-states, and TUG were significantly less than those at pretraining (T0). During both the ST and the DT situations, gait performance and spatial memory cognitive performance significantly improved from T0 to T2. CONCLUSION: The present study demonstrated that cognitive-cycling DT training improves the motor functions, gait and cognitive performances of PD patients.

Effects of Cycling Dual-Task on Cognitive and Physical Function in Parkinson’s Disease: A Randomized Double-Blind Pilot Study

“…This means that those patients had participated in an intervention with a cycling protocol; however, they were assessed using a walking dual task and not a cycling dual task. Unlike in our pilot study, where we observed a deterioration of cycling performance, the aforementioned authors [30] observed improvements in different gait parameters while the cognitive task was being performed. It should be noted that, in our study, the different measurement tools were used at the beginning of the study and once again, seven weeks after the intervention had ended, except for the cycling performance parameters, which were collected at the same time as the cycling + cognitive task was performed.…”

“…Regarding the development of the cycling task, the concomitance of the cognitive task generated a difficult element in its performance, although without generating, for example, changes in symmetry between hemi bodies or Heart Rate. In the study by Chang et al [30], gait parameters were evaluated while Parkinson's patients performed different cognitive tasks associated with walking; one of them related to calculations, another with spatial orientation and finally one was carried out using the STROOP test. In that study, the total cycling time was 30 min for five-eight sessions, 35 min for nine-twelve sessions, and 40 min for thirteen-sixteen sessions.…”

The Impact of Motor-Cognitive Dual-Task Training on Physical and Cognitive Functions in Parkinson’s Disease

“…Previous studies found that motor symptoms were improved after dual-task training [ 18 , 19 , 20 ]. Twenty patients were randomized into a 24-session single-modal training group (performing gait and cognitive training sequentially) or a dual-task training group (performing gait and cognitive training simultaneously).…”

“…The improvement in motor symptoms could be preserved for at least 4 weeks [ 18 ]. Another study found that the shorter session of cognitive-cycling training (16 sessions) also showed benefits [ 20 ]. The Hoehn–Yahr stage of the included patients ranged from two to three, indicating that the dual-task training was suitable for mild to moderate PD [ 18 , 19 , 20 ].…”

“…Another study found that the shorter session of cognitive-cycling training (16 sessions) also showed benefits [ 20 ]. The Hoehn–Yahr stage of the included patients ranged from two to three, indicating that the dual-task training was suitable for mild to moderate PD [ 18 , 19 , 20 ]. Some studies assessed motor function outcomes using other scales.…”