The Influence of a Cognitive Task on the Postural Phase of Gait Initiation in Parkinson’s Disease: An Electromyographic-Based Analysis

Fernandes, Ângela; Sousa, Andreia S. P.; Rocha, Nuno; Tavares, João Manuel R. S.

doi:10.1123/mc.2015-0032

Cited by 10 publications

(6 citation statements)

References 35 publications

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“…Besides, patients in the initial stages of PD should perform dual-task training to prevent or delay these deficits 42. In a recent study, Fernandes et al (2017)44 showed that the anticipatory postural adjustments during gait initiation were impaired in patients with PD. The authors reported an activation failure of the tibialis anterior muscle in both single- and dual-task conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Although patients reported mobility improvement, the authors failed to find a significant effect of VR step climbing training on TUG performance. Based on the study by Fernandes et al (2017), an electromyographic-based analysis may be more sensitive for detecting postural control improvement than TUG, particularly in early-stage PD patients 44…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is virtual reality beneficial for dual-task gait training in patients with Parkinson's disease? A systematic review

Freitag¹,

Brucki

Barbosa³

et al. 2019

Dement. neuropsychol.

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This systematic review examined the evidence about the effects of virtual reality (VR) on dual-task gait training in Parkinson's disease (PD). Methods: this study (PROSPERO registration CRD42019114736) aimed to answer the question: “Is VR beneficial for dual-task gait training in patients with PD?” We searched for studies from 2008 to 2018 on Medline/PubMed and Web of Science/Web of knowledge databases. The keywords were Parkinson AND gait training AND virtual reality OR Parkinson AND gait training AND game. A total of 55 articles were retrieved, of which 11 systematic reviews, 11 opinions, letters to the editor, posters or conferences abstracts and 17 studies not evaluating the effects of VR gait training were excluded. Three further studies addressing VR dual-task gait training in PD (found in references of studies selected) were also included. Therefore, 19 studies were included and analysed. Results: all studies reported gait improvement after VR training. Many clinical scales were used, hampering comparison of the effects of each protocol. Conclusion: VR dual-task gait training should be part of rehabilitation protocols for PD. The studies showed that VR training was effective, although specific guidelines have not yet been established.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is virtual reality beneficial for dual-task gait training in patients with Parkinson's disease? A systematic review

Freitag¹,

Brucki

Barbosa³

et al. 2019

Dement. neuropsychol.

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“…Cognitive decline in early PD has been associated with worse motor and non-motor symptoms, suggesting that this reflects a faster progressive phenotype (80). Postural control strategies are strictly correlated to cognitive performance, and Fernandes et al (81) found that cognitive tasks might improve the postural control strategies during gait initiation.…”

Section: Cognition Symptomsmentioning

confidence: 99%

Non-pharmacological Treatment Challenges in Early Parkinson's Disease for Axial and Cognitive Symptoms: A Mini Review

et al. 2020

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Background: Parkinson's disease (PD) is now known to be a multisystemic heterogeneous neurodegenerative disease, including a wide spectrum of both motor and non-motor symptoms. PD patients' management must encompass a multidisciplinary approach to effectively address its complex nature. There are still challenges in terms of treating axial (gait, balance, posture, speech, and swallowing) and cognitive symptoms that typically arise with disease progression becoming poorly responsive to dopaminergic or surgical treatments. Objective: The objectives of the study are to further establish the presentation of axial and cognitive symptoms in early PD [Hoehn and Yahr (H&Y) scale ≤ 2] and to discuss the evidence for non-pharmacological approaches in early PD. Results: Mild and subtle changes in the investigated domains can be present even in early PD. Over the last 15 years, a few randomized clinical trials have been focused on these areas. Due to the low number of studies and the heterogeneity of the results, no definitive recommendations are possible. However, positive results have been obtained, with effective treatments being high-intensity treadmill and cueing for gait disturbances, high-intensity voice treatment, video-assisted swallowing therapy for dysphagia, and warm-up exercises and Wii Fit TM training for cognition. Conclusions: Considering the association of motor, speech, and cognitive function, future trials should focus on multidisciplinary approaches to combined non-pharmacological management. We highlight the need for a more unified approach in managing these "orphan" symptoms, from the very beginning of the disease. The concept "the sooner the better" should be applied to multidisciplinary non-pharmacological management in PD.

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“…It is well known that when a concurrent cognitive task is performed by PD patients, there is an impairment in the performance of the primary task 1,2,4,10,12,[36][37][38][39][40][41][42] . Our results are in accordance with those in the literature; however, the vast majority of studies have introduced a competing cognitive task with walking tasks 1,4,12,36,37,[39][40][41][42] . The novelty of our study focused on the effect of the performance of dual tasks and other motor skills, including sit-to-stand.…”

Section: Discussionmentioning

confidence: 99%

“…Individuals with Parkinson's disease (PD) have motor performance impairment in dual-task (DT) conditions [1][2][3][4] due loss of automaticity and reduced cognitive resources, including the ability to divide their attentional demand between competing tasks 5,6 . These deficits increase the risk of falling and restrict the performance of the activities of daily living 2,7,8 .…”

Section: Introductionmentioning

confidence: 99%

Dual-task demands in various motor skills through Parkinson’s disease progression

Freitas

Silva

Nuvolini

et al. 2019

Motriz: rev. educ. fis.

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The aim of this study was to investigate the effects of adding a cognitive task on the performance of three different motor tasks with different demands, discrete skills, serial skills and continuous skills, by individuals with mild, moderate, and severe idiopathic Parkinson' disease (PD). We also investigate the effect of the cognitive task in the secondary task and the cost of the dual-task. Method: This is a cross-sectional study. Individuals with idiopathic PD were divided in three groups with respect to motor severity (mild, moderate and severe groups). Participants' performances were assessed in single and DT conditions including Sit-to-Stand test (SST), Timed Up and Go (TUG), and 10-meter Walk test (T10W). Cognitive task used was verbal fluency Results: The results show that dual task impact the performance of all primary tasks. DT negatively affects the performance of the motor tasks. And there is a different impact according the severity of the disease, severe ones are more affected than mild and moderate. Conclusion: In conclusion, adding a concurrent cognitive task negatively affected the performance of discrete, serial and continuous motor tasks, and this effect is more noticeable in severe than in mild patients. Under dual-task conditions, patients improved their cognitive task performance for gait and TUG, suggesting a prioritization of the secondary task for these tasks. There was no difference between the costs of the three tasks.

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The Influence of a Cognitive Task on the Postural Phase of Gait Initiation in Parkinson’s Disease: An Electromyographic-Based Analysis

Cited by 10 publications

References 35 publications

Is virtual reality beneficial for dual-task gait training in patients with Parkinson's disease? A systematic review

Is virtual reality beneficial for dual-task gait training in patients with Parkinson's disease? A systematic review

Non-pharmacological Treatment Challenges in Early Parkinson's Disease for Axial and Cognitive Symptoms: A Mini Review

Dual-task demands in various motor skills through Parkinson’s disease progression

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