Background: Parkinson’s disease (PD) results in a global decrease in information processing, ultimately resulting in dysfunction executing motor-cognitive tasks. Motor-cognitive impairments contribute to postural instability, often leading to falls and decreased physical activity. The aim of this study was to determine the effects of a multimodal training (MMT) versus single-modal (SMT) training on motor symptoms, fall frequency, and physical activity in patients with PD classified as fallers. Methods: Individuals with PD were randomized into SMT (n = 11) or MMT (n = 10) and completed training 3 times per week for 8 weeks. The SMT completed gait and cognitive training separately, whereas MMT completed gait and cognitive training simultaneously during each 45-minute session. Physical activity, 30-day fall frequency, and PD motor symptoms were assessed at baseline, posttreatment, and during a 4-week follow-up. Results: Both groups exhibited significant (P < .05) improvements in clinical ratings of motor function, as symptoms improved by 8% and 15% for SMT and MMT, respectively. Physical activity significantly increased (P < .05) for both groups from baseline (mean steps 4942 ) to posttreatment (mean steps 5914 ). The MMT resulted in a significant 60% reduction in falls. Conclusions: Although SMT and MMT approaches are both effective in improving physical activity and motor symptoms of PD, only MMT reduced fall frequency after the intervention.
Amanda L. Penko, Jacob E. Barkley, Anson B. Rosenfeldt and Jay L. Alberts
Anson B. Rosenfeldt, Amanda L. Penko, Andrew S. Bazyk, Matthew C. Streicher, Tanujit Dey and Jay L. Alberts
The aim of this project was to (a) evaluate the potential of the 2-min walk test to detect declines in gait velocity under dual-task conditions and (b) compare gait velocity overground and on a self-paced treadmill in Parkinson’s disease (PD). In total, 23 individuals with PD completed the 2-min walk test under single- and dual-task (serial 7s) conditions overground and on a self-paced treadmill. There was a significant decrease in gait velocity from single- to dual-task conditions overground (1.32 ± 0.22 to 1.10 ± 0.25 m/s; p < .001) and on the self-paced treadmill (1.24 ± 0.21 to 1.05 ± 0.25 m/s; p < .001). Overground and treadmill velocities were not statistically different from each other; however, differences approached or exceeded the minimal clinical important difference. The 2-min walk test coupled with a cognitive task provides an effective model of identifying dual-task declines in individuals with PD. Further studies comparing overground and self-paced treadmill velocity is warranted in PD.