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IMPROVEMENT OF GAIT, FUNCTIONAL AND COGNITIVE PERFORMANCE IN PATIENTS WITH PARKINSON’S DISEASE AFTER GAIT TRAINING ASSOCIATED WITH EXECUTIVE FUNCTION TASKS.

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Presentation on theme: "IMPROVEMENT OF GAIT, FUNCTIONAL AND COGNITIVE PERFORMANCE IN PATIENTS WITH PARKINSON’S DISEASE AFTER GAIT TRAINING ASSOCIATED WITH EXECUTIVE FUNCTION TASKS."— Presentation transcript:

1 IMPROVEMENT OF GAIT, FUNCTIONAL AND COGNITIVE PERFORMANCE IN PATIENTS WITH PARKINSON’S DISEASE AFTER GAIT TRAINING ASSOCIATED WITH EXECUTIVE FUNCTION TASKS The purpose of this study was to compare the effectiveness of gait training associated with executive function tasks versus gait training alone, to improve gait, functional performance and cognitive functions in PD patients. CONCLUSION EFGT was found more effective compared to GT for improving motor and cognitive performance in PD patients. IMPLICATIONS The findings of this study demonstrate the importance of motor training associated with cognitive functions to attenuate the functional impairments in PD patients, and thereby show that despite automatic motor control dysfunctions and cognitive deficiencies, performance of this patient group on multiple tasks can be improved. MOTOR DEFICIENCY LACK IN AUTOMATIC CONTROL COGNITIVE DEFICIENCY DISRUPTION IN EXECUTIVE FUNCTION GAIT IMPAIRMENT IN DAILY LIVING ACTIVITIES DESIGN: Double-blinded, randomized, controlled, longitudinal clinical trial PARTICIPANTS: 20 patients with idiopathic PD, mean age of 68.5 years (S.D = 5.24), 12 men and 8 women, at stages 1 and 2 of the disease according to the Hoehn and Yahr Classification, and asymptomatic for depression and dementia. All participants signed the HCFMUSP informed consent term. CONTROL TRAINING In the GT, gait was trained using the same trajectory and over the same period of time but with no associated tasks. Patients from both groups were instructed to stride as quickly as possible. FOLLOW-UP 30 DAYS AFTER END OF TRAINING ASSESSMENT AFTER TRAINING 7 DAYS AFTER END OF TRAINING INTERVENTION 10 SESSIONS (2 PER WEEK) ASSESSMENT BEFORE TRAINING ALLOCATED TO INTERVENTION RANDOMIZED EXCLUDED (DID NOT MEET INCLUSION CRITERIA) ASSESSED FOR ELEGIBILITY N=28 N=8 20 EXECUTIVE FUNCTION GAIT TRAINING (EFGT) N=10 N=10 GAIT TRAINING (GT) N=10N=10 OUTCOME MEASURES PRIMARY – DYNAMIC GAIT INDEX SECUNDARY – MONTREAL COGNITIVE ASSESSMENT (MoCa) – UNIFED PARKINSONS DISEASE RATING SCALE (UPDRS) EXECUTIVE FUNCTION GAIT TRAINING DATA ANALYSIS The following measures were compared: (1) Unified Parkinson Disease Rating Scale (UPDRS), for assessing functionality; (2) Montreal Cognitive Assessment (MOCA), for assessing cognitive functions; and (3) Dynamic Gait Index (DGI), for functional gait performance before training (BT), 7 days (AT), 30 days(FOLLOW- UP) after end of training, using ANOVA for repeated measures RESULTS The results revealed significant interaction between training types (EFGT and GT) and assessments (BT; AT; FOLLOW-UP) on UPDRS, MOCA and DGI scores (ANOVA, p< 0.001), confirmed by Tukey’s post-hoc test which showed that EFGT led to superior improvement and retention compared to GT. BEDESCHI, C; PIEMONTE, MEP Department of Physical Therapy, Faculty of Medical Science - University of Sao Paulo MOTOR COMPONENTS CUES OR ATTENTIONAL GAIT TRAINING STIMULATE THE CORTICAL CONTROL ON GAIT DECREASE CORTICAL RESOURCES AVAILABLE FOR OTHER TASKS MOTOR AND COGNITIVE COMPONENTS GAIT TRAINING ASSOCIATED WITH EXECUTIVE FUNCTION TASKS STIMULATE THE AUTOMATIC CONTROL ON GAIT IMPROVE THE FUNDAMENTALEXECUTIVE FUNCTIONS NEEDED TO SUPPORT THE FUNCTIONAL GAIT


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