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

Uncorking the limitation-improving dual tasking using transcranial electrical stimulation and task training in the elderly: a systematic review

Introduction

With aging, dual task (DT) ability declines and is more cognitively demanding than single tasks. Rapidly declining DT performance is regarded as a predictor of neurodegenerative disease. Task training and non-invasive transcranial electrical stimulation (tES) are methods applied to optimize the DT ability of the elderly.

Methods

A systematic search was carried out in the PUBMED, TDCS (transcranial direct current stimulation) databases, as well as Web of Science, and a qualitative analysis was conducted in 56 included studies. Aiming to summarize the results of studies that implemented tES, task training, or the combination for improving DT ability and related performance changes in healthy elderly and geriatric patients. For different approaches, the training procedures, parameters, as well as outcomes were discussed.

Results

Task training, particularly cognitive-motor DT training, has more notable effects on improving DT performance in the elderly when compared to the neuromodulation method.

Discussion

Anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (L-DLPFC), or its combination with task training could be promising tools. However, additional evidence is required from aged healthy people and patients, as well as further exploration of electrode montage.

The Impact of Motor-Cognitive Dual-Task Training on Physical and Cognitive Functions in Parkinson’s Disease

Rehabilitation is a high-potential approach to improving physical and cognitive functions in Parkinson’s disease (PD). Dual-task training innovatively combines motor and cognitive rehabilitation in a comprehensive module. Patients perform motor and cognitive tasks at the same time in dual-task training. The previous studies of dual-task training in PD had high heterogeneity and achieved controversial results. In the current review, we aim to summarize the current evidence of the effect of dual-task training on motor and cognitive functions in PD patients to support the clinical practice of dual-task training. In addition, we also discuss the current opinions regarding the mechanism underlying the interaction between motor and cognitive training. In conclusion, dual-task training is suitable for PD patients with varied disease duration to improve their motor function. Dual-task training can improve motor symptoms, single-task gait speed, single-task steep length, balance, and objective experience of freezing of gait in PD. The improvement in cognitive function after dual-task training is mild.

Effects of Cycling Dual-Task on Cognitive and Physical Function in Parkinson’s Disease: A Randomized Double-Blind Pilot Study

(1) Background: Those with Parkinson’s disease (PD) may present difficulties in performing dual tasks (DT). The use of DT during training can improve different abilities. Therefore, the objective of this study is to verify the influence of a cycling exercise program combined with a cognitive task on cognitive and physical PD aspects; (2) Methods: A double-blind, randomized pilot study was undertaken. Participants performed a DT intervention composed of cycling and a cognitive task. The cycling parameters, MDS-UPDRS, PDQ-39, TUG Test, 30 s Chair Sit to Stand test and Stroop were used to measure outcomes; (3) Results: DT generated impairment in performing the cycling task, with significant differences in cycling parameters, active and passive distance (m), total work (W) and active speed (rpm). At the cognitive level, there was a trend of improvement in the group that performed the training with DT, which improved by 211%; (4) Conclusions: Combining cycling with a cognitive task caused impairment in the performance of the physical task and an improvement at the cognitive level. Therefore, combining cycling with a cognitive task in a presumably safer environment for patients with PD can be a good way to train these patients for the dual-task challenges with practical applications.