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Effects of Dual-Task Group Training on Gait, Cognitive Executive Function, and Quality of Life in People With Parkinson Disease: Results of Randomized Controlled DUALGAIT Trial

  • Constanza San Martín Valenzuela
    Affiliations
    Unit of Personal Autonomy, Dependency and Mental Disorder Assessment, Faculty of Medicine, Universitat de València, València, Spain

    Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, València, Spain

    UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, València, Spain

    Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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  • Lirios Dueñas Moscardó
    Affiliations
    Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, València, Spain
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  • Juan López-Pascual
    Affiliations
    Instituto de Biomecánica de Valencia, Universitat Politècnica de València, València, Spain
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  • Pilar Serra-Añó
    Correspondence
    Corresponding author Pilar Serra-Añó, PhD, Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, C/Gascó Oliag 5, 46010 València, Spain.
    Affiliations
    Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, València, Spain

    UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, València, Spain
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  • José M. Tomás
    Affiliations
    Department of Behavioral Sciences Methodology, Faculty of Psychology, Universitat de València, València, Spain
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Published:August 11, 2020DOI:https://doi.org/10.1016/j.apmr.2020.07.008

      Highlights

      • This was a single-blind randomized controlled trial, with 8 weeks of follow-up study.
      • Dual-task gait training was compared with gait training in Parkinson disease.
      • Training effects were evaluated in single- and dual-task conditions.
      • The dual-task training group demonstrated improved velocity, stride length, and double support time.
      • Dual-task training has a greater effect on single gait and visual dual-task gait.

      Abstract

      Objectives

      The aims of this study were to analyze the effects of a dual-task group program, to compare it with the effects of a single-task group program, and to analyze the effects of functional secondary tasks.

      Design

      Single-blind randomized controlled trial.

      Setting

      University laboratory and a rehabilitation gym at a health center.

      Participants

      Patients (N=40) with a diagnosis of Parkinson disease (mean age, 66.72y; age range, 44-79y) with Hoehn and Yahr stage I to III who were on medication were randomized to either a group with dual-task training or a group with single-task training (only gait).

      Intervention

      Both interventions involved 20 sessions lasting 1 hour each and conducted twice a week. Dual-task training included walking exercises and cognitive or motor tasks carried out separately, then later performed together as a dual-task according to a progressive protocol in the same training session.

      Main Outcome Measures

      Velocity and spatiotemporal parameters of gait were measured without a secondary task and during dual-task gait combined with a visual, verbal, auditory, and motor task. In addition, executive cognitive function and quality of life were measured. Assessments were conducted at baseline, postrehabilitation, and at the 8-week follow-up.

      Results

      The dual-task group demonstrated improved velocity and stride length time in all assessment conditions after training (P<.05), as well as perceived quality of life (P<.05). The single-task group experienced improvements in the same outcomes for only the motor condition (P<.05) after training, but failed to improve perceived quality of life (P>.05). Likewise, the dual-task group showed higher velocity and stride length after treatment than the single-task group across conditions. No significant changes were observed in cognitive performance (P>.05), although the dual-task group tended to improve performance during the executive function test.

      Conclusions

      Dual-task training in functional contexts is associated with greater improvements in velocity and stride length in patients with PD compared with regular physiotherapy without secondary tasks. Dual-task training also improves perceived quality of life.

      Keywords

      List of abbreviations:

      DT (dual-task), MANOVA (multivariate analysis of variance), PD (Parkinson disease), ST (single-task)
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