SEATTLE — What is the effect of baseline cognition on gait outcomes after a treadmill training program for Parkinson’s disease (PD) patients?
A pilot clinical trial sought to answer that question. Researchers from the VA Puget Sound Healthcare System in Seattle include PD patients who were classified as having no cognitive impairment (PD-NCI) or mild cognitive impairment (PD-MCI), assessing baseline executive function and memory.
A report in the journal Disability & Rehabilitation noted that the intervention was a 10-week gait-training program involving twice-weekly treadmill sessions. The sessions included structured speed and distance progression and verbal cues for gait quality. The study team assessed response to intervention by gait speed measured after Week 2 (short-term) and Week 10 (long-term).
The 19 participants—12 of whom had no cognitive impairment and seven who had mild cognitive impairment—had a mean (standard deviation) age of 66.5 (6.3) years, disease duration of 8.8 (6.3) years and MDS-UPDRS III score of 21.3 (10.7).
The researchers reported that gait speed increased at short-term and long-term assessments. “The response did not differ between PD-NCI and PD-MCI groups; however, better baseline memory performance and milder PD motor severity were independently associated with greater improvements in gait speed in unadjusted and adjusted models,” they wrote.
The authors advised that their findings suggest that memory impairments and more-severe motor involvement can influence the response to gait rehabilitation in PD, and highlight the need for treatments optimized for people with greater cognitive and motor impairment.
“Cognitive deficits in Parkinson’s disease (PD) could impact motor learning and gait rehabilitation, yet little is known about the effects of cognitive impairments on the response to rehabilitation in people with PD,” the researchers explained. This study demonstrates that the response to gait rehabilitation did not differ between people with PD who had no cognitive impairment and those with mild cognitive impairment. Across all participants, better baseline memory was associated with greater improvements in gait speed. Rehabilitation professionals should be mindful of PD severity, as those with more substantial memory and motor impairments may require additional dosing or support to maximize gait training benefits.
- Amin RM, Phillips JJ, Humbert AT, Cholerton BA, Short VD, Smith MJ, Zabetian CP, Mata IF, Kelly VE. Associations between baseline cognitive status and motor outcomes after treadmill training in people with Parkinson’s disease: a pilot study. Disabil Rehabil. 2023 Apr 3:1-10. doi: 10.1080/09638288.2023.2189318. Epub ahead of print. PMID: 37010072.
