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Rozenberg D, Reid WD, Camp P, Campos JL, Dechman G, Davenport PW, Egan H, Fisher JH, Guenette JA, Gold D, Goldstein RS, Goodridge D, Janaudis-Ferreira T, Kaplan AG, Langer D, Marciniuk DD, Moore B, Orchanian-Cheff A, Otoo-Appiah J, Pepin V, Rassam P, Rotenberg S, Ryerson C, Spruit MA, Stanbrook MB, Stickland MK, Tom J, Wentlandt K. Translating the Interplay of Cognition and Physical Performance in COPD and Interstitial Lung Disease: Meeting Report and Literature Review. Chest 2024:S0012-3692(24)00707-4. [PMID: 38901488 DOI: 10.1016/j.chest.2024.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 06/22/2024] Open
Abstract
TOPIC IMPORTANCE Cognitive and physical limitations are common in individuals with chronic lung diseases, but their interactions with physical function and activities of daily living are not well characterized. Understanding these interactions and potential contributors may provide insights on disability and enable more tailored rehabilitation strategies. REVIEW FINDINGS This review summarizes a 2-day meeting of patient partners, clinicians, researchers, and lung associations to discuss the interplay between cognitive and physical function in people with chronic lung diseases. This report covers four areas: (1) cognitive-physical limitations in patients with chronic lung diseases; (2) cognitive assessments; (3) strategies to optimize cognition and motor control; and (4) future research directions. Cognitive and physical impairments have multiple effects on quality of life and daily function. Meeting participants acknowledged the need for a standardized cognitive assessment to complement physical assessments in patients with chronic lung diseases. Dyspnea, fatigue, and age were recognized as important contributors to cognition that can affect motor control and daily physical function. Pulmonary rehabilitation was highlighted as a multidisciplinary strategy that may improve respiratory and limb motor control through neuroplasticity and has the potential to improve physical function and quality of life. SUMMARY There was consensus that cognitive function and the cognitive interference of dyspnea in people with chronic lung diseases contribute to motor control impairments that can negatively affect daily function, which may be improved with pulmonary rehabilitation. The meeting generated several key research questions related to cognitive-physical interactions in individuals with chronic lung diseases.
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Affiliation(s)
- Dmitry Rozenberg
- Temerty Faculty of Medicine, Respirology, Krembil Brain Institute, Toronto, ON, Canada; Respirology, University Health Network, Toronto, ON, Canada; Toronto General Hospital Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
| | - W Darlene Reid
- Department of Physical Therapy, Krembil Brain Institute, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, Krembil Brain Institute, Toronto, ON, Canada; KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Pat Camp
- Department of Physical Therapy, The University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, BC, Canada
| | - Jennifer L Campos
- Department of Psychology, Krembil Brain Institute, Toronto, ON, Canada; KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Gail Dechman
- School of Physiotherapy, Faculty of Health, Dalhousie University; Department of Medicine, Respirology, Nova Scotia Health Authority
| | | | - Helga Egan
- Lung Health Foundation, Toronto, ON, Canada
| | - Jolene H Fisher
- Temerty Faculty of Medicine, Respirology, Krembil Brain Institute, Toronto, ON, Canada; Respirology, University Health Network, Toronto, ON, Canada
| | - Jordan A Guenette
- Department of Physical Therapy, The University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, Providence Research, The University of British Columbia and St Paul's Hospital, Vancouver, BC, Canada; Division of Respiratory Medicine, The University of British Columbia, Gordon and Leslie Diamond Health Care Centre, Vancouver, BC, Canada
| | - David Gold
- Department of Psychiatry, Krembil Brain Institute, Toronto, ON, Canada; Neuropsychology Clinic, University Health Network, Toronto, ON, Canada
| | - Roger S Goldstein
- Temerty Faculty of Medicine, Respirology, Krembil Brain Institute, Toronto, ON, Canada; Department of Respiratory Medicine, Westpark Healthcare Centre, Toronto, ON, Canada
| | - Donna Goodridge
- College of Medicine, Respiratory Research Center, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Alan G Kaplan
- Department of Family and Community Medicine, School of Graduate Studies, Temerty Faculty of Medicine, Toronto, ON, Canada; Family Physician Airways Group of Canada
| | - Daniel Langer
- KU Leuven, Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, Leuven, Belgium; Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Darcy D Marciniuk
- Division of Respirology, Critical Care and Sleep Medicine, Respiratory Research Center, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Ani Orchanian-Cheff
- Library and Information Services, University Health Network, Toronto, ON, Canada
| | - Jessica Otoo-Appiah
- Department of Physical Therapy, Krembil Brain Institute, Toronto, ON, Canada
| | - Veronique Pepin
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QB, Canada
| | - Peter Rassam
- Department of Physical Therapy, Krembil Brain Institute, Toronto, ON, Canada; Rehabilitation Sciences Institute, School of Graduate Studies, Temerty Faculty of Medicine, Toronto, ON, Canada
| | - Shlomit Rotenberg
- Department of Occupational Science & Occupational Therapy, Rehabilitation Sciences Institute, Toronto, ON, Canada; Rotman Research Institute, Baycrest, Toronto, ON, Canada
| | - Chris Ryerson
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, Providence Research, The University of British Columbia and St Paul's Hospital, Vancouver, BC, Canada
| | - Martijn A Spruit
- Department of Research and Development, Ciro, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Matthew B Stanbrook
- Temerty Faculty of Medicine, Respirology, Krembil Brain Institute, Toronto, ON, Canada; Respirology, University Health Network, Toronto, ON, Canada
| | - Michael K Stickland
- Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada; G.F. MacDonald Centre for Lung Health, Covenant Health, Edmonton, AB, Canada
| | | | - Kirsten Wentlandt
- Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Department of Supportive Care, University Health Network, Toronto, ON, Canada
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Longhurst JK, Rider JV, Cummings JL, John SE, Poston B, Landers MR. Cognitive-motor dual-task interference in Alzheimer's disease, Parkinson's disease, and prodromal neurodegeneration: A scoping review. Gait Posture 2023; 105:58-74. [PMID: 37487365 DOI: 10.1016/j.gaitpost.2023.07.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/20/2022] [Accepted: 07/13/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Cognitive-motor interference (CMI) is a common deficit in Alzheimer's (AD) disease and Parkinson's disease (PD) and may have utility in identification of prodromal neurodegeneration. There is lack of consensus regarding measurement of CMI resulting from dual task paradigms. RESEARCH QUESTION How are individuals with AD, PD, and prodromal neurodegeneration impacted by CMI as measured by dual-task (DT) performance? METHODS A systematic literature search was performed in six datasets using the PRISMA guidelines. Studies were included if they had samples of participants with AD, PD, or prodromal neurodegeneration and reported at least one measure of cognitive-motor DT performance. RESULTS 4741 articles were screened and 95 included as part of this scoping review. Articles were divided into three non-mutually exclusive groups based on diagnoses, with 26 articles in AD, 56 articles in PD, and 29 articles in prodromal neurodegeneration, and results presented accordingly. SIGNIFICANCE Individuals with AD and PD are both impacted by CMI, though the impact is likely different for each disease. We found a robust body of evidence regarding the utility of measures of DT performance in the detection of subtle deficits in prodromal AD and some signals of utility in prodromal PD. There are several key methodological challenges related to DT paradigms for the measurement of CMI in neurodegeneration. Overall, DT paradigms show good potential as a clinical method to probe specific brain regions, networks, and function; however, task selection and effect measurement should be carefully considered.
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Affiliation(s)
- Jason K Longhurst
- Department of Physical Therapy and Athletic Training, Saint Louis University, 3437 Caroline St. Suite, 1011 St. Louis, MO, USA.
| | - John V Rider
- School of Occupational Therapy, Touro University Nevada, Henderson, NV, USA; Department of Physical Therapy, University of Nevada, Las Vegas, NV, USA.
| | | | - Samantha E John
- Department of Brain Health, University of Nevada, Las Vegas, NV, USA.
| | - Brach Poston
- Department of Kinesiology and Nutrition, University of Nevada, Las Vegas, NV, USA.
| | - Merrill R Landers
- Department of Physical Therapy, University of Nevada, Las Vegas, NV, USA.
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Hanada M, Tanaka T, Kozu R, Ishimatsu Y, Sakamoto N, Orchanian-Cheff A, Rozenberg D, Reid WD. The interplay of physical and cognitive function in rehabilitation of interstitial lung disease patients: a narrative review. J Thorac Dis 2023; 15:4503-4521. [PMID: 37691666 PMCID: PMC10482628 DOI: 10.21037/jtd-23-209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 07/04/2023] [Indexed: 09/12/2023]
Abstract
Background and Objective Interstitial lung disease (ILD) encompasses several diverse pulmonary pathologies that result in abnormal diffuse parenchymal changes. When prescribing rehabilitation, several additional factors need to be considered as a result of aging, polypharmacy, and comorbidities manifested in ILD patients. This review aims to discuss issues related to frailty, skeletal muscle and cognitive function that limit physical activities in ILD patients. It will also highlight exercise training and propose complementary strategies for pulmonary rehabilitation. Methods A literature search was performed in MEDLINE, CINAHL (inception to October 19th, 2022) using search terms based on concepts of: idiopathic pulmonary fibrosis or interstitial lung disease; frailty; muscular atrophy; skeletal muscle dysfunction; cognitive dysfunction; sleep quality; sleep disorders; anxiety disorders; or depressive disorders. After eligible texts were screened, additional references were included from references cited in the screened articles. Key Content and Findings Frailty and skeletal muscle dysfunction are common in ILD. Weight loss, exhaustion, and anti-fibrotic medications can impact frailty, whereas physical inactivity, aging, corticosteroids and hypoxemia can contribute to sarcopenia (loss of muscle mass and function). Frailty is associated with worse clinical status, exercise intolerance, skeletal muscle dysfunction, and decreased quality of life in ILD. Sarcopenia appears to influence wellbeing and can potentially affect overall physical conditioning, cognitive function and the progression of ILD. Optimal assessment tools and effective strategies to prevent and counter frailty and sarcopenia need to be determined in ILD patients. Even though cognitive impairment is evident in ILD, its prevalence and underlying neurobiological model of contributing factors (i.e., inflammation, disease severity, cardiopulmonary status) requires further investigation. How ILD affects cognitive interference, motor control and consequently physical daily activities is not well defined. Strategies such as pulmonary rehabilitation, which primarily focuses on strength and aerobic conditioning have demonstrated improvements in ILD patient outcomes. Future incorporation of interval training and the integration of motor learning could improve transfer of rehabilitation strategies to daily activities. Conclusions Numerous underlying etiologies of ILD contribute to frailty, skeletal muscle and cognitive function, but their respective neurobiologic mechanisms require further investigation. Exercise training increases physical measures, but complementary approaches may improve their applicability to improve daily activities.
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Affiliation(s)
- Masatoshi Hanada
- Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takako Tanaka
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryo Kozu
- Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yuji Ishimatsu
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ani Orchanian-Cheff
- Library and Information Services, University Health Network, Toronto, Canada
| | - Dmitry Rozenberg
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Respirology, Ajmera Transplant Program, Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | - W. Darlene Reid
- Department of Physical Therapy, University of Toronto, Toronto, Canada
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
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Rozenberg D, Shore J, Camacho Perez E, Nourouzpour S, Ibrahim Masthan M, Santa Mina D, Campos JL, Huszti E, Green R, Khan MH, Lau A, Gold D, Stanbrook MB, Reid WD. Feasibility of a Home-Based Cognitive-Physical Exercise Program in Patients With Chronic Obstructive Pulmonary Disease: Protocol for a Feasibility and Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e48666. [PMID: 37436794 PMCID: PMC10372770 DOI: 10.2196/48666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/25/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a progressive condition associated with physical and cognitive impairments contributing to difficulty in performing activities of daily living (ADLs) that require dual tasking (eg, walking and talking). Despite evidence showing that cognitive decline occurs among patients with COPD and may contribute to functional limitations and decreased health-related quality of life (HRQL), pulmonary rehabilitation continues to focus mainly on physical training (ie, aerobic and strength exercises). An integrated cognitive and physical training program compared to physical training alone may be more effective in increasing dual-tasking ability among people living with COPD, leading to greater improvements in performance of ADLs and HRQL. OBJECTIVE The aims of this study are to evaluate the feasibility of an 8-week randomized controlled trial of home-based, cognitive-physical training versus physical training for patients with moderate to severe COPD and derive preliminary estimates of cognitive-physical training intervention efficacy on measures of physical and cognitive function, dual task performance, ADLs, and HRQL. METHODS A total of 24 participants with moderate to severe COPD will be recruited and randomized into cognitive-physical training or physical training. All participants will be prescribed an individualized home physical exercise program comprising 5 days of moderate-intensity aerobic exercise (30-50 minutes/session) and 2 days of whole-body strength training per week. The cognitive-physical training group will also perform cognitive training for approximately 60 minutes, 5 days per week via the BrainHQ platform (Posit Science Corporation). Participants will meet once weekly with an exercise professional (via videoconference) who will provide support by reviewing the progression of their training and addressing any queries. Feasibility will be assessed through the recruitment rate, program adherence, satisfaction, attrition, and safety. The intervention efficacy regarding dual task performance, physical function, ADLs, and HRQL will be evaluated at baseline and at 4 and 8 weeks. Descriptive statistics will be used to summarize intervention feasibility. Paired 2-tailed t tests and 2-tailed t tests will be used to compare the changes in the outcome measures over the 8-week study period within and between the 2 randomized groups, respectively. RESULTS Enrollment started in January 2022. It is estimated that the enrollment period will be 24 months long, with data collection to be completed by December 2023. CONCLUSIONS A supervised home-based cognitive-physical training program may be an accessible intervention to improve dual-tasking ability in people living with COPD. Evaluating the feasibility and effect estimates is a critical first step to inform future clinical trials evaluating this approach and its effects on physical and cognitive function, ADL performance, and HRQL. TRIAL REGISTRATION ClinicalTrials.gov NCT05140226; https://clinicaltrials.gov/ct2/show/NCT05140226. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48666.
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Affiliation(s)
- Dmitry Rozenberg
- Respirology and Lung Transplantation, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Josh Shore
- Division of Respirology, University Health Network, Toronto, ON, Canada
| | | | - Sahar Nourouzpour
- Division of Respirology, University Health Network, Toronto, ON, Canada
| | | | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, University Health Network, Toronto, ON, Canada
| | - Jennifer L Campos
- Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Ella Huszti
- Biostatistics Research Unit, University Health Network, Toronto, ON, Canada
| | - Robin Green
- Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, ON, Canada
| | | | - Ambrose Lau
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Respirology, University Health Network, Toronto, ON, Canada
| | - David Gold
- Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Matthew B Stanbrook
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Respirology, University Health Network, Toronto, ON, Canada
| | - W Darlene Reid
- Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
- Interdivisional Department of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
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5
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Guess TM, Bliss R, Hall JB, Kiselica AM. Comparison of Azure Kinect overground gait spatiotemporal parameters to marker based optical motion capture. Gait Posture 2022; 96:130-136. [PMID: 35635988 DOI: 10.1016/j.gaitpost.2022.05.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Instrumented measurement of spatiotemporal parameters during walking can provide valuable information on an individual's overall function and health. Efficient, inexpensive, and accurate measurement of overground walking spatiotemporal parameters would be a critical component of providing point-of-care assessments of gait function, concussion recovery, fall-risk, and cognitive decline. Depth cameras combined with skeleton pose tracking algorithms, such as the Microsoft Kinect with body tracking software, have been used to measure walking spatiotemporal parameters. However, the ability of the latest generation Microsoft Kinect sensor, the Azure Kinect, to accurately measure overground walking spatiotemporal parameters has not been evaluated in the literature. RESEARCH QUESTION The purpose of this work was to compare overground walking spatiotemporal parameters measurements from a 12 camera Vicon optical motion capture system to measurements of a single Azure Kinect with body tracking SDK (software development kit). METHODS Spatiotemporal parameters of overground walking were simultaneously collected on twenty young healthy participants. Stride length, stride time, step length and step width were derived from ankle joint center locations and measurements from the two instruments were compared using descriptive statistics, scatter plots, Pearson correlation analyses, and Bland-Altman analyses. RESULTS Pearson correlation coefficients were greater than 0.87 for all spatiotemporal parameters with most parameters demonstrating very strong (> 0.9) agreement. The mean of the differences for stride length between measurements was 35.6 mm for the left limb and 39.1 mm for the right limb, both of which are less than 3% of average stride length. Mean of the differences for step width and stride time were less than 2% and 1% of their averages respectively. SIGNIFICANCE A single Microsoft Azure Kinect with body tracking SDK can provide clinically relevant measurement of walking spatiotemporal parameters, providing accessible and objective measurements that can improve clinical decision making across a variety of patient populations.
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Affiliation(s)
- Trent M Guess
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA; Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA.
| | - Rebecca Bliss
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA
| | - Jamie B Hall
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA
| | - Andrew M Kiselica
- Department of Health Psychology, University of Missouri, Columbia, MO, USA
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Longhurst JK, Rider JV, Cummings JL, John SE, Poston B, Held Bradford EC, Landers MR. A Novel Way of Measuring Dual-Task Interference: The Reliability and Construct Validity of the Dual-Task Effect Battery in Neurodegenerative Disease. Neurorehabil Neural Repair 2022; 36:346-359. [PMID: 35387509 DOI: 10.1177/15459683221088864] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Decreased automaticity is common among individuals with neurodegenerative disease and is often assessed using dual-task (DT) paradigms. However, the best methods for assessing performance changes related to DT demands remain inconclusive. OBJECTIVE To investigate the reliability and validity of a novel battery of DT measures (DT Effect-Battery (DTE-B)) encompassing three domains: task-specific interference, task prioritization, and automaticity. METHODS Data for this retrospective cross-sectional study included 125 participants with Parkinson's disease (PD), 127 participants with Alzheimer's disease (AD), and 84 healthy older adults. Reliability analyses were conducted using a subset of each population. DTE-B measures were calculated from single and DT performance on the Timed Up and Go test and a serial subtraction task. Construct validity was evaluated via associations within the DTE-B and with theoretically supported measures as well as known-groups validity analyses. RESULTS Good to excellent reliability was found for DTE-B measures of task interference (motor and cognitive DT effects) (ICCs≥.658) and automaticity (combined DT effect (cDTE)) (ICCs≥.938). Evidence for convergent validity was found with associations within the hypothesized constructs. Known-groups validity analyses revealed differences in the DTE-B among the healthy group and PD and AD groups (ps≤.001), excepting task prioritization (ps≥.061). CONCLUSIONS This study provides evidence to support the DTE-B as a reliable measure of multiple constructs pertinent to DT performance. The cDTE demonstrated evidence to support its validity as a measure of automaticity. Further investigation of the utility of the DTE-B in both PD and AD, as well as other populations, is warranted.
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Affiliation(s)
- Jason K Longhurst
- 15994Saint Louis University, St. Louis, MO, USA.,59432University of Nevada, Las Vegas, NV, USA.,Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - John V Rider
- 15994Touro University Nevada, Henderson, NV, USA.,59432University of Nevada, Las Vegas, NV, USA
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7
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Pinto SS, Bezerra EDES, Silva KG, Ramirez-Campillo R, Ben Abderrahman A. Acute Effects of Velocity-Based Resistance Training on the Physical Functional Performance of Older Adults. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2022; 15:399-413. [PMID: 36895435 PMCID: PMC9987528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
The aim of this study was to analyse the acute effects of velocity-based resistance training on the physical and functional performance of older adults. Twenty participants (70.4 ± 7.4 years) performed the deadlift exercise, in two different resistance training protocols. The moderate-velocity protocol (MV) predicted maximum loads so that the movement velocity during the concentric phase remained in the range of 0.5 to 0.7 m/s and the high-velocity protocol (HV) predicted maximum loads so that the movement velocity remained between 0.8 and 1.0 m/s. The jump height (cm), handgrip strength (kg), and time (s) to complete the functional tests were assessed before (baseline), and immediately (post), 24-h, and 48-h after the MV and HV protocols. Compared to baseline, both training protocols acutely led to a gradual reduction in walking velocity, with significant values 24 hours after training (p = 0.044), on the other hand, both protocols improved performance in the timed up and go test at post (p < 0.001) and in the sit-to-stand test at 48-h (p = 0.024), although there were no significant differences between them for any times analysed (p > 0.05). No other outcomes exhibited significant changes. Results indicate that neither of the protocols (MV and HV) led to significant impairments in physical function of the older adults, and can be recommended with the safety criterion of at least 48-h of rest between sessions.
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Affiliation(s)
- Suzy S Pinto
- Higher Institute of Spot and Physical Education of Ksar Saïd, University of Manouba, Manouba, TUNISIA
| | | | - Keuly G Silva
- Human Performance Laboratory, Federal University of Amazonas, Manaus, BRAZIL
| | - Rodrigo Ramirez-Campillo
- Human Performance Laboratory, Department of Physical Activity Sciences, University of Los Lagos, Osorno, CHILE.,Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, CHILE
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Liebert A, Bicknell B, Laakso EL, Heller G, Jalilitabaei P, Tilley S, Mitrofanis J, Kiat H. Improvements in clinical signs of Parkinson's disease using photobiomodulation: a prospective proof-of-concept study. BMC Neurol 2021; 21:256. [PMID: 34215216 PMCID: PMC8249215 DOI: 10.1186/s12883-021-02248-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 05/18/2021] [Indexed: 12/27/2022] Open
Abstract
Background Parkinson’s disease (PD) is a progressive neurodegenerative disease with no cure and few treatment options. Its incidence is increasing due to aging populations, longer disease duration and potentially as a COVID-19 sequela. Photobiomodulation (PBM) has been successfully used in animal models to reduce the signs of PD and to protect dopaminergic neurons. Objective To assess the effectiveness of PBM to mitigate clinical signs of PD in a prospective proof-of-concept study, using a combination of transcranial and remote treatment, in order to inform on best practice for a larger randomized placebo-controlled trial (RCT). Methods Twelve participants with idiopathic PD were recruited. Six were randomly chosen to begin 12 weeks of transcranial, intranasal, neck and abdominal PBM. The remaining 6 were waitlisted for 14 weeks before commencing the same treatment. After the 12-week treatment period, all participants were supplied with PBM devices to continue home treatment. Participants were assessed for mobility, fine motor skills, balance and cognition before treatment began, after 4 weeks of treatment, after 12 weeks of treatment and the end of the home treatment period. A Wilcoxon Signed Ranks test was used to assess treatment effectiveness at a significance level of 5%. Results Measures of mobility, cognition, dynamic balance and fine motor skill were significantly improved (p < 0.05) with PBM treatment for 12 weeks and up to one year. Many individual improvements were above the minimal clinically important difference, the threshold judged to be meaningful for participants. Individual improvements varied but many continued for up to one year with sustained home treatment. There was a demonstrable Hawthorne Effect that was below the treatment effect. No side effects of the treatment were observed. Conclusions PBM was shown to be a safe and potentially effective treatment for a range of clinical signs and symptoms of PD. Improvements were maintained for as long as treatment continued, for up to one year in a neurodegenerative disease where decline is typically expected. Home treatment of PD by the person themselves or with the help of a carer might be an effective therapy option. The results of this study indicate that a large RCT is warranted. Trial registration Australian New Zealand Clinical Trials Registry, registration number: ACTRN12618000038291p, registered on 12/01/2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02248-y.
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Affiliation(s)
- Ann Liebert
- School of Medical Sciences, University of Sydney, Camperdown, Australia. .,Governance and Research Department, Sydney Adventist Hospital, Wahroonga, Australia.
| | - Brian Bicknell
- Faculty of Health Sciences, Australian Cathlic University, North Sydney, Australia
| | - E-Liisa Laakso
- Mater Research Institute, South Brisbane, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Gillian Heller
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia.,Department of Mathematics and Statistics, Macquarie University, Macquarie Park, Australia
| | | | | | - John Mitrofanis
- Department of Anatomy, University of Sydney, Camperdown, Australia
| | - Hosen Kiat
- Faculty of medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia.,Faculty of Medicine, University of NSW, Kensington, Australia.,Cardiac Health Institute, Sydney, Australia
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9
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Ozinga SJ, Baron E, Koop MM, Bazyk A, Alberts JL. Errors in cognitive performance trigger postural instability in Parkinson's disease. Parkinsonism Relat Disord 2021; 86:91-96. [PMID: 33895539 DOI: 10.1016/j.parkreldis.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/19/2021] [Accepted: 04/06/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Globally, postural stability and cognitive performance are intimately linked in Parkinson's disease (PD). However, a fundamental gap exists in understanding the precise relationship between a disruption in executive function and its impact on postural stability. OBJECTIVE This project aimed to determine the precise effects of cognitive errors on postural stability under dual-task conditions in participants with PD and controls. METHODS Twenty-eight individuals with PD and 27 healthy controls completed a series of postural stability tests under single- and dual-tasks. The dual-task required maintenance of balance while performing an audio number discrimination task. RESULTS In general, postural stability in PD and control subjects was similar across single-task conditions. In controls, an error in the cognitive task during dual-task conditions did not impact measures of postural sway. In contrast, in PD, postural sway increased in epochs surrounding cognitive errors relative to epochs without errors. CONCLUSIONS Postural task selection plays a critical role when testing for balance deficits in PD compared to healthy controls. Furthermore, time synchronized analysis of cognitive and balance data revealed the greatest episodes of postural instabilities occurred around cognitive errors. The measurement and evaluation of cognitive-motor linkages, relative to postural stability, could provide a patient-specific fingerprint of balance function and provide more sensitive measures for fall risk in PD.
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Affiliation(s)
- Sarah J Ozinga
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Elise Baron
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Mandy Miller Koop
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Andrew Bazyk
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jay L Alberts
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA.
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10
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Frisaldi E, Bottino P, Fabbri M, Trucco M, De Ceglia A, Esposito N, Barbiani D, Camerone EM, Costa F, Destefanis C, Milano E, Massazza G, Zibetti M, Lopiano L, Benedetti F. Effectiveness of a dance-physiotherapy combined intervention in Parkinson's disease: a randomized controlled pilot trial. Neurol Sci 2021; 42:5045-5053. [PMID: 33743108 DOI: 10.1007/s10072-021-05171-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/06/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Physical therapies have been recommended as crucial components in Parkinson's disease (PD) rehabilitation. OBJECTIVE The study aims to examine the effectiveness of a new dance-physiotherapy combined intervention, called DArT method, in mild PD patients. METHODS A prospective, randomized, single-blind, controlled pilot trial was conducted on 38 mild PD patients under dopaminergic therapy. The intervention consisted in an add-on protocol: the control group received 1 h of conventional physiotherapy followed by 1 h of conventional physiotherapy each day, 3 times a week, for 5 weeks. The experimental group received 1 h of conventional physiotherapy followed by 1 h of dance class each day, 3 times a week, for 5 weeks. The week before and after the training period, patients were assessed for motor, cognitive, emotional, and sensory components of PD, with MDS-UPDRS-III as primary outcome measure. RESULTS DArT method was associated with a 2.72-point reduction in the post-treatment MDS-UPDRS-III total score compared to control group (95% CI - 5.28, - 0.16, p = 0.038, d = 0.71), and with a 2.16-point reduction in the post-treatment MDS-UPDRS-III upper body subscore (95% CI - 3.56, - 0.76, p = 0.003, d = 1.02). Conversely, conventional physiotherapy program was associated with a 2.95-point reduction in the post-treatment trait anxiety compared to the experimental group (95% CI 0.19, 5.71, p = 0.037, d = 0.70). Withdrawal and fall rates were equal to 0% in both groups. CONCLUSION DArT method showed to be safe, well accepted, and more effective than an intensive program of conventional physiotherapy in improving motor impairment in mild PD.
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Affiliation(s)
- Elisa Frisaldi
- Rita Levi-Montalcini Department of Neuroscience, University of Turin Medical School, corso Raffaello 30, 10125, Turin, Italy.
| | - Piero Bottino
- Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Turin, Italy
| | - Margherita Fabbri
- Rita Levi-Montalcini Department of Neuroscience and Regional Reference Center of Movement Disorders, University of Turin Medical School, Turin, Italy.,Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Centre, NS-Park/FCRIN Network and Neuro Toul COEN Centre; Toulouse University Hospital; INSERM; University of Toulouse 3, Toulouse, France
| | - Marco Trucco
- Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Turin, Italy
| | - Alessandra De Ceglia
- Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Turin, Italy
| | - Nadia Esposito
- Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Turin, Italy
| | - Diletta Barbiani
- Rita Levi-Montalcini Department of Neuroscience, University of Turin Medical School, corso Raffaello 30, 10125, Turin, Italy
| | - Eleonora Maria Camerone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
| | - Federico Costa
- Division of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Cristina Destefanis
- Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Turin, Italy
| | - Edoardo Milano
- Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Turin, Italy
| | - Giuseppe Massazza
- Division of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Maurizio Zibetti
- Rita Levi-Montalcini Department of Neuroscience and Regional Reference Center of Movement Disorders, University of Turin Medical School, Turin, Italy
| | - Leonardo Lopiano
- Rita Levi-Montalcini Department of Neuroscience and Regional Reference Center of Movement Disorders, University of Turin Medical School, Turin, Italy
| | - Fabrizio Benedetti
- Rita Levi-Montalcini Department of Neuroscience, University of Turin Medical School, corso Raffaello 30, 10125, Turin, Italy.,Medicine and Physiology of Hypoxia, Plateau Rosà, Switzerland
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11
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Costa KGD, Hussey EK, Fontes EB, Menta A, Ramsay JW, Hancock CL, Loverro KL, Marfeo E, Ward N. Effects of Cognitive Over Postural Demands on Upright Standing Among Young Adults. Percept Mot Skills 2020; 128:80-95. [PMID: 33198565 DOI: 10.1177/0031512520972879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A growing body of research has shown that static stance control (e.g., body sway) is influenced by cognitive demands (CD), an effect that may be related to competition for limited central resources. Measures of stance control have also been impacted by postural demands (PD) (e.g., stable vs. unstable stances). However, less is known of any possible interactions between PD and CD on static stance control in populations with intact balance control and ample cognitive resources, like young healthy adults. In this study, among the same participants, we factorially compared the impact of PD with and without CD on static stance control. Thirty-four healthy young adults wore inertial measurement units (IMU) while completing static stance tasks for 30 seconds in three different PD positions: feet apart, feet together, and tandem feet. After completing these tasks alone, participants performed these tasks with CD by concurrently completing verbal serial seven subtractions from a randomly selected three-digit number. For two dependent measures, path length and jerk, there were main effects of CD and PD but no interaction effect between these factors. For all other stance control parameters, there was only a PD main effect. Thus, adding a cognitive demand to postural demands, while standing upright, may have an independent impact on stance control, but CD does not seem to interact with PD. These results suggest that young healthy adults may be less sensitive to simple PD and CD due to their greater inherent balance control and available cognitive resources. Future work might explore more complex PD and CD combinations to determine the boundaries under which young adults' resources are taxed.
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Affiliation(s)
- Kell Grandjean da Costa
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, Massachusetts, United States
- Department of Psychology, Tufts University, Medford, Massachusetts, United States
| | - Erika K Hussey
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, Massachusetts, United States
- U.S. Army CCDC Soldier Center, Natick, Massachusetts, United States
| | - Eduardo Bodnariuc Fontes
- Department of Psychology, Tufts University, Medford, Massachusetts, United States
- Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil
| | - Alekya Menta
- Department of Psychology, Tufts University, Medford, Massachusetts, United States
| | - John W Ramsay
- U.S. Army CCDC Soldier Center, Natick, Massachusetts, United States
| | | | - Kari L Loverro
- U.S. Army CCDC Soldier Center, Natick, Massachusetts, United States
| | - Elizabeth Marfeo
- Department of Occupational Therapy, Tufts University, Medford, Massachusetts, United States
| | - Nathan Ward
- Department of Psychology, Tufts University, Medford, Massachusetts, United States
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12
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Ünlüer NÖ, Ateş Y, Balbaba A, Sücüllü Karadağ Y. Investigation of non-motor symptoms, balance, muscle strength, and functional mobility in patients with parkinson's disease. Somatosens Mot Res 2020; 38:20-26. [PMID: 33131377 DOI: 10.1080/08990220.2020.1834377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Although both motor symptoms and non-motor symptoms (NMSs) occur in patients with Parkinson's disease (PD), clinical practice focuses more on motor symptoms. The aim of this study was to examine balance, muscle strength, and mobility in relation with NMSs in patients with PD. The other aim of this study was to investigate the relationship between NMSs and muscle strength, balance, and functional mobility in PD. MATERIALS AND METHODS The study included 24 patients with PD (between Hoehn & Yahr Stage 1 and 3) and 20 healthy individuals of similar age and sex. The participants' balance was assessed with the Biodex Balance System (Biodex Medical Systems, Shirley, NY, USA), muscle strength assessments were conducted with a Biodex® System 4 Dynamometer device, and functional mobility was assessed with the Timed Up and Go test (TUG). The non-motor symptoms scale was used for NMSs. RESULTS We found that lower extremity strength scores were lower and NMSs, balance, and mobility scores were greater in patients with PD in comparison to healthy controls (p < 0.05). The correlation analysis revealed that higher NMSs were related to reduced knee extension strength and cognitive dual task performance. CONCLUSION Although no relationship between NMSs and balance was observed, the relationship between the TUG + cognitive task and muscle strength suggests that NMSs should be carefully evaluated along with the motor symptoms, which deteriorate beginning with the early period.
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Affiliation(s)
- Nezehat Özgül Ünlüer
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Yasemin Ateş
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Ayşe Balbaba
- Department of Physiotherapy and Rehabilitation, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Yeşim Sücüllü Karadağ
- Department of Neurology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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13
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Shin D, Kang EK. Dual-task interference is related to attentional level in healthy farmers: An observational study. Medicine (Baltimore) 2020; 99:e20720. [PMID: 32629646 PMCID: PMC7337427 DOI: 10.1097/md.0000000000020720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Dual-task interference (DTI) is a decreased performance when conducting 2 tasks simultaneously, such as cognitive and motor tasks. This study aimed to identify the DTI-related factors with individually computerized interference and analyze the relative implications of decreasing DTI in healthy farmers.It followed 3 computerized experiments:The reaction time of correct releases (CRT) of BT1 in all tasks was measured, and the CRT ratios of DT were divided by the CRT values from CT and MT to obtain the DTI value. CRT during CT and MT was decreased compared to that during DT. The interference by CT (CRT of DT/CRT of MT × 100, CTI) was increased compared to the interference by MT (CRT of DT/CRT of CT×100, MTI). Additionally, comprehensive baseline characteristics, body composition, psycho-cognitive, and physical factors were assessed.Of a total of 54 participants, 16 are males (67.2 ± 8.9 years) and 38 females (62.5 ± 6.6 years). CTI showed significant correlations with age (r = 0.436, P < .001), farming period (r = 0.290, P = .033), score of the Mini-Mental State Examination in the Korean version of CERAD Assessment Packet (r = -0.329, P = .015), CRT of the Go/No-Go test (r = 0.67, P < .001), score of the short physical performance battery (r = -0.304, P = .026), and time of the timed up and go test (r = 0.364, P = .007). Regression analysis showed that the CRT of the Go/No-Go test (β = 0.558, P < .001) was the most explanatory factors for CTI.Based on the individualized DTI values quantified, interference during cognitive task was mostly related to CRT of Go/No-Go test, reflecting the attentional level. These results could suggest strategies for the active attentional training to reduce DTI and passive simplification and modification of lifestyles.
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Affiliation(s)
- Dabi Shin
- Department of Rehabilitation Medicine, Kangwon National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Eun Kyoung Kang
- Department of Rehabilitation Medicine, Kangwon National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea
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14
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The repeatability of the instrumented timed Up & Go test: The performance of older adults and parkinson’s disease patients under different conditions. Biocybern Biomed Eng 2020. [DOI: 10.1016/j.bbe.2019.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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15
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de Oliveira Silva F, Ferreira JV, Plácido J, Chagas D, Praxedes J, Guimarães C, Batista LA, Marinho V, Laks J, Deslandes AC. Stages of mild cognitive impairment and Alzheimer’s disease can be differentiated by declines in timed up and go test: A systematic review and meta-analysis. Arch Gerontol Geriatr 2019; 85:103941. [DOI: 10.1016/j.archger.2019.103941] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 08/07/2019] [Accepted: 08/23/2019] [Indexed: 10/26/2022]
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16
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The Dual-Tasking Overload on Functional Mobility Is Related to Specific Cognitive Domains in Different Subtypes of Parkinson's Disease. TOPICS IN GERIATRIC REHABILITATION 2019. [DOI: 10.1097/tgr.0000000000000220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Kang EK, Shin D, Yun JY, Park W, Park HW. Investigating the interference pattern of dual tasks using serial decomposition. Restor Neurol Neurosci 2018; 36:639-646. [PMID: 30056440 DOI: 10.3233/rnn-180825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Specific investigation of dual task-interference (DTI) may help researchers to develop the optimal training exercise for enhancing the performance of daily activities. OBJECTIVES To reveal the DTI by comparing the performances between personalized single tasks (cognitive or motor task) and dual task with serial decomposition in normal healthy adults. METHODS After a preliminary period, healthy participants randomly (n = 46) performed three computerized experiments of cognitive (CT), motor (MT) and dual tasks (DT). In CT, participants were required to release button 1 (BT1) as rapidly as possible when the font color of a word and its meaning were congruent (Go), and in MT, they had to release BT1 and then tap button 2 (BT2) 10 times as rapidly as possible if the symbol "○" was presented (Go). The DT consisted of a combination of CT and MT elements. The reaction time (RT) of correct releases (RTCR) of BT1 in all tasks was measured, as well as the button shifting time between releasing BT1 and pressing BT2, and the finger tapping rate in MT and DT. To obtain the DTI values, we calculated the RTCR ratio in CT and MT and divided the outcome by the RTCR of DT. RESULTS The ratio of RTCR in CT (% CT/DT, 78.6±13.0%) and MT (% MT/DT, 74.2±10.1%) were significantly lower than the ratio of RTCR in DT (% DT/DT, 100%). The button shifting time of MT was at 92.0±23.7% of baseline, and the finger tapping rate of MT was 106.1±19.1%, which was significantly higher than baseline. CONCLUSIONS The % DT/DT is significantly higher than both % CT/DT and % MT/DT, which suggests that the cognitive load depends on the type of cognitive task that is being performed. Additionally, the significant increase of % DT/DT compared to % CT/DT indicated that there is a cognitive load prior to a motor task. The increased button shifting time and decreased tapping rate in DT may indicate that a residual cognitive load and a concurrent motor load were present.
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Affiliation(s)
- Eun Kyoung Kang
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea.,Department of Rehabilitation Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Dabi Shin
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea.,Department of Rehabilitation Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Jeong-Yeon Yun
- Gangwon Do Rehabilitation Hospital, Chuncheon, Republic of Korea.,Department of Forensic Science, College of Health Science, Yonsei University, Wonju, Republic of Korea
| | - Wanjoo Park
- New York University Abu Dhabi, Engineering Division, Abu Dhabi, United Arab Emirates
| | - Hee-Won Park
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea.,Department of Rehabilitation Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.,Gangwon Do Rehabilitation Hospital, Chuncheon, Republic of Korea
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18
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Heraud N, Alexandre F, Gueugnon M, Davy C, Tremey E, Oliver N, Varray A. Impact of Chronic Obstructive Pulmonary Disease on Cognitive and Motor Performances in Dual-Task Walking. COPD 2018; 15:277-282. [PMID: 29799281 DOI: 10.1080/15412555.2018.1469607] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
When two tasks are performed simultaneously, they compete for attentional resources, resulting in a performance decrement in one or both tasks. Patients with attention disorders have a reduced ability to perform several tasks simultaneously (e.g., talking while walking), which increases the fall risk and frailty. This study assessed the cognitive and motor performances of patients with COPD and healthy controls within a dual-task walking paradigm. A subobjective was to assess the impact of a pulmonary rehabilitation program on the dual-task performances in COPD. Twenty-five patients with COPD and 20 controls performed a cognitive task (subtraction) and a 15-m walking test separately (single-task; ST) and jointly (dual-task; DT). In addition, a subsample of 10 patients performed the same evaluations 5 weeks later after a pulmonary rehabilitation program following current recommendations. Cognitive and gait performances in ST showed no differences between patients with COPD and controls (all p > 0.05). However, COPD patients exhibited a greater increase in gait variability than controls in DT (4.07 ± 1.46% vs. 2.17 ± 0.7%, p < 0.001). The pulmonary rehabilitation program had no effect on the dual-task impairment for the subsample of patients (p = 0.87). This study provides evidence of insufficient attentional resources to successfully deal with DT in patients with COPD, and this was expressed through an exaggerated increase in gait variability in DT walking. Given the high risk of falls and disability associated with altered gait variability, dual-task training interventions should be considered in pulmonary rehabilitation programs.
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Affiliation(s)
- Nelly Heraud
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France
| | - François Alexandre
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France
| | - Mathieu Gueugnon
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France
| | - Corentin Davy
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France
| | - Emilie Tremey
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France
| | - Nicolas Oliver
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France
| | - Alain Varray
- a Cliniques du Souffle , Service Recherche , Groupe 5 Sante, Lodeve , France.,b Euromov, University of Montpellier , Montpellier , France
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19
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Benefits of Exercise on the Executive Functions in People with Parkinson Disease: A Controlled Clinical Trial. Am J Phys Med Rehabil 2017; 96:301-306. [PMID: 27584142 DOI: 10.1097/phm.0000000000000612] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE We have made a 3-arm trial (group vs. individual exercise vs. no treatment) to test the effects of a 6-month exercise program upon the executive functions in participants with Parkinson disease. METHODS Twenty-four subjects were randomly allocated in 3 groups and undertook individualized exercises (G1, n = 8), group exercises (G2, n = 8), or monitoring (G3, n = 8). Executive functions were evaluated by means of the Wisconsin card sorting test and the Raven colored matrices, both assessed at the beginning of the program and after 6 months. The statistical analyses consisted of the application of repeated measurement tests, with a significant level of 5%. RESULTS The findings showed similar behavior of groups in terms of the Wisconsin card sorting test (P = 0.792), reporting no benefit of the program on such instrument. Differently, Raven colored matrices evidenced a significant benefit provided by the intervention (P = 0.032). Compared with the control group, individuals from G1 had a substantial improvement on executive functions (P = 0.031) and from G2 had a trend of significance (P = 0.072). CONCLUSION Findings of this study show that 6 months of exercise improved some aspects of executive functions when compared with control peers. Individual therapy seems to have a more prominent improvement than group therapy.
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20
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Barbosa AF, Chen J, Freitag F, Valente D, Souza CDO, Voos MC, Chien HF. Gait, posture and cognition in Parkinson's disease. Dement Neuropsychol 2016; 10:280-286. [PMID: 29213470 PMCID: PMC5619266 DOI: 10.1590/s1980-5764-2016dn1004005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Gait disorders and postural instability are the leading causes of falls and
disability in Parkinson's disease (PD). Cognition plays an important role in
postural control and may interfere with gait and posture assessment and
treatment. It is important to recognize gait, posture and balance dysfunctions
by choosing proper assessment tools for PD. Patients at higher risk of falling
must be referred for rehabilitation as early as possible, because
antiparkinsonian drugs and surgery do not improve gait and posture in PD.
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Affiliation(s)
- Alessandra Ferreira Barbosa
- Physical Therapy, Occupational Therapy and Speech Therapy Department, University of São Paulo School of Medicine, São Paulo, SP, Brazil.,ReMove. Rehabilitation of Movement Disorders Research Group
| | - Janini Chen
- Movement Disorders Clinic of Hospital das Clinicas of the Department of Neurology. University of São Paulo School of Medicine, São Paulo, SP, Brazil.,ReMove. Rehabilitation of Movement Disorders Research Group
| | - Fernanda Freitag
- Movement Disorders Clinic of Hospital das Clinicas of the Department of Neurology. University of São Paulo School of Medicine, São Paulo, SP, Brazil
| | - Debora Valente
- Movement Disorders Clinic of Hospital das Clinicas of the Department of Neurology. University of São Paulo School of Medicine, São Paulo, SP, Brazil.,ReMove. Rehabilitation of Movement Disorders Research Group
| | - Carolina de Oliveira Souza
- Movement Disorders Clinic of Hospital das Clinicas of the Department of Neurology. University of São Paulo School of Medicine, São Paulo, SP, Brazil.,ReMove. Rehabilitation of Movement Disorders Research Group
| | - Mariana Callil Voos
- Physical Therapy, Occupational Therapy and Speech Therapy Department, University of São Paulo School of Medicine, São Paulo, SP, Brazil.,ReMove. Rehabilitation of Movement Disorders Research Group
| | - Hsin Fen Chien
- Movement Disorders Clinic of Hospital das Clinicas of the Department of Neurology. University of São Paulo School of Medicine, São Paulo, SP, Brazil.,ReMove. Rehabilitation of Movement Disorders Research Group.,Institute of Orthopedics and Traumatology of Hospital das Clínicas of University of São Paulo School of Medicine, São Paulo, SP, Brazil
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21
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Christofoletti G, Felippe LA, Müller PDT, Beinotti F, Borges G. Cognitive processes affect the gait of subjects with Parkinson’s and Alzheimer’s disease in dual tasks. JORNAL BRASILEIRO DE PSIQUIATRIA 2015. [DOI: 10.1590/0047-2085000000071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective To investigate the relation between gait parameters and cognitive impairments in subjects with Parkinson’s disease (PD) and Alzheimer’s disease (AD) during the performance of dual tasks. Methods This was a cross-sectional study involving 126 subjects divided into three groups: Parkinson group (n = 43), Alzheimer group (n = 38), and control group (n = 45). The subjects were evaluated using the Timed Up and Go test administered with motor and cognitive distracters. Gait analyses consisted of cadence and speed measurements, with cognitive functions being assessed by the Brief Cognitive Screening Battery and the Clock Drawing Test. Statistical procedures included mixed-design analyses of variance to observe the gait patterns between groups and tasks and the linear regression model to investigate the influence of cognitive functions in this process. A 5% significant level was adopted. Results Regarding the subjects’ speed, the data show a significant difference between group vs task interaction (p = 0.009), with worse performance of subjects with PD in motor dual task and of subjects with AD in cognitive dual task. With respect to cadence, no statistical differences was seen between group vs task interaction (p = 0.105), showing low interference of the clinical conditions on such parameter. The linear regression model showed that up to 45.79%, of the variance in gait can be explained by the interference of cognitive processes. Conclusion Dual task activities affect gait pattern in subjects with PD and AD. Differences between groups reflect peculiarities of each disease and show a direct interference of cognitive processes on complex tasks.
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22
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Lin KC, Wu YF, Chen IC, Tsai PL, Wu CY, Chen CL. Dual-Task Performance Involving Hand Dexterity and Cognitive Tasks and Daily Functioning in People With Schizophrenia: A Pilot Study. Am J Occup Ther 2015; 69:6903250020p1-7. [DOI: 10.5014/ajot.2014.014738] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. This study investigated separate and concurrent performance on cognitive and hand dexterity tasks and the relationship to daily functioning in 16 people with schizophrenia and 16 healthy control participants.
METHOD. Participants performed the Purdue Pegboard Test and the Serial Seven Subtraction Test under single- and dual-task conditions and completed two daily functioning evaluations.
RESULTS. The hand dexterity of all participants declined in the dual-task condition, but the discrepancy between single-task and dual-task hand dexterity was greater in the schizophrenia group than in the control group (p < .03, d > .70, for all). The extent of discrepancy in hand dexterity was negatively correlated with daily functioning in the schizophrenia group (rs = −.3 to −.5, ps = .04–.26).
CONCLUSION. Ability to perform dual tasks may be an indicator of daily functioning in people with schizophrenia. Use of dual-task training may be considered as a therapeutic activity with these clients.
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Affiliation(s)
- Keh-chung Lin
- Keh-chung Lin, ScD, is Professor, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei
| | - Yi-fang Wu
- Yi-fang Wu, MS, is Occupational Therapist, Department of Psychiatry, National Taiwan University Hospital, Taipei
| | - I-chen Chen
- I-chen Chen, MS, is Research Assistant, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei
| | - Pei-luen Tsai
- Pei-luen Tsai, PhD, is Associate Professor, Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-yi Wu
- Ching-yi Wu, ScD, is Professor and Chair, Department of Occupational Therapy, College of Medicine, Chang Gung University, Tao-Yuan County, Taiwan;
| | - Chia-ling Chen
- Chia-ling Chen, PhD, is Professor, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Tao-Yuan County, Taiwan
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Brucki SMD. Timed Up and Go test: a simple test gives important information in elderly. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 73:185-6. [PMID: 25807121 DOI: 10.1590/0004-282x20140243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 02/18/2015] [Indexed: 11/22/2022]
Affiliation(s)
- Sonia Maria Dozzi Brucki
- Grupo de Neurologia Cognitiva e Comportamental, Universidade de São Paulo, Sao Paulo, SP, Brazil
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Marzinzik F, Herrmann A, Gogarten JH, Lueschow A, Weber JE, Schindlbeck KA, Klostermann F. Dysfunctional action control as a specific feature of Parkinson's disease. J Neural Transm (Vienna) 2014; 122:1125-33. [PMID: 25547860 DOI: 10.1007/s00702-014-1354-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 12/17/2014] [Indexed: 10/24/2022]
Abstract
Parkinson's disease (PD) is characterised by motor deficits as well as cognitive alterations, particularly concerning frontal lobe control. Here, we were interested in whether executive function is abnormal already early in PD, as well as whether this dysfunction worsens as a part of the dementia in PD. The following groups engaged in tasks addressing action control: PD patients with mild and advanced motor symptoms (aPD) without dementia, PD patients with dementia (PDD), patients with Alzheimer's disease (AD) and healthy subjects (CON). Subjects either had to perform or inhibit button presses upon go and no-go cues, respectively. These cues were preceded by pre-cues, either randomly instructive of right or left hand preparation (switch condition), or repetitively instructive for one side only (non-switch condition). PDD and aPD omitted more go responses than CON. Furthermore, PDD disproportionally committed failures upon no-go cues compared to CON. In the non-switch condition, PDD performed worse than AD, whose deficits increased to the level of PDD in the switch condition. Over all PD patients, task performance correlated with disease severity. Under the switch condition, task performance was low in both PDD and AD. In the non-switch condition, this also held true for advanced PD patients (with and without dementia), but not for AD. Thus, the deficits evident in PDD appear to develop from imbalanced inhibitory-to-excitatory action control generally inherent to PD. These results specify the concept of dysexecution in PD and differentiate the cognitive profile of PDD from that of AD patients.
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