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

Article type: Research Article

Authors: Chang, Hsiu-Chen^{a; c; g; †} | Chen, Chiung-Chu^{a; b; d; †} | Weng, Yi-Hsin^{a; b} | Chiou, Wei-Da^{c; f} | Chang, Ya-Ju^{b; c; e; *} | Lu, Chin-Song^{b; g; *}

Affiliations: [a] Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan | [b] Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan | [c] School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan | [d] School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan | [e] Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan | [f] Department of Physical Rehabilitation, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan | [g] Professor Lu Neurological Clinic, Taoyuan, Taiwan

Correspondence: [*] Address for correspondence: Professor Chin-Song Lu, Professor Lu Neurological Clinic, Taoyuan, Taiwan, 2F, No. 10, Aly. 41, Ln. 10, Wenhua 1st Rd., Guishan Dist., Taoyuan 333, Taiwan. Tel.: +886 3 396 0388; Fax: +886 3 396 0378; E-mail: [email protected] and Professor Ya-Ju Chang, School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, 259, Wen-Hwa 1st Rd., Kweishan, Taoyuan, Taiwan. Tel.: +886 3 211 8800; Fax: +886 3 211 8700; E-mail: [email protected].

Note: [†] Contributed equally.

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 single-task 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.

Keywords: Parkinson’s disease, cycling, cognitive, dual-task, gait

DOI: 10.3233/NRE-203090

Journal: NeuroRehabilitation, vol. 47, no. 4, pp. 415-426, 2020