Walking deficits and altered brain capacity have been proved to be two of the main contributing factors in dual-task walking deficits in patients with Parkinson's disease (PD). In the past, patients with PD were usually suggested not to walk in dual-task conditions in order to concentrate on their walking performance better. However, since dual-task walking is really common in daily-life, this limitation usually lead to a decrease in quality of life for PD patients. In previous studies, effects of using attentional strategies in dual-task walking training remain unclear, while suitable attentional strategies and corresponded neuroplasticity for patients with and without freezing of gait have not been well discussed, either. Accordingly, this study is aimed to identify (1) whether internal or external attentional strategies is more ideal for PD patients with and without freezing of gait in dual-task walking training, and (2) changes in brain activity after receiving dual-task walking training with different attentional strategies in patients with or without freezing of gait. Our hypothesis are (1) patients with or without freezing of gait will react differently in dual-gait training with different attentional strategies, and (2) changes in brain activities will be different according to different attentional strategies given in the training.
The hypothesis will be tested by gait performance, suprapostural tasks performance, relative power spectrum of EEG, and scales including MDS-UPDRS, ABC, BBS, and TUG.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
50
Participants will be instructed to perform both motor and cognitive dual-task walking during exercise training. For example, for motor dual-task walking, the participants may be instructed to throw and catch a ball while walking. As for cognitive dual-task walking, the participants may be instructed to name animals or perform calculation while walking.
School and Graduate Institute of Physical Therapy, National Taiwan University
Taipei, Taiwan
Gait velocity from GAITRite
gait performance
Time frame: 60 minutes
Cadence from GAITRite
gait performance
Time frame: 60 minutes
Mean step length from GAITRite
gait performance
Time frame: 60 minutes
Step-to-step variability from GAITRite
gait performance
Time frame: 60 minutes
Amplitude from a triaxial accelerometer, X axes
motor suprapostural task performance
Time frame: 25 minutes
Amplitude from a triaxial accelerometer, Y axes
motor suprapostural task performance
Time frame: 25 minutes
Amplitude from a triaxial accelerometer, Z axes
motor suprapostural task performance
Time frame: 25 minutes
Correct rate on working memory task
cognitive suprapostural task performance
Time frame: 25 minutes
EEG relative power in the delta band
brain activity under single, motor dual-task, and cognitive dual-task walking conditions
Time frame: 60 minutes
EEG relative power in the theta band
brain activity under single, motor dual-task, and cognitive dual-task walking conditions
Time frame: 60 minutes
EEG relative power in the alpha band
brain activity under single, motor dual-task, and cognitive dual-task walking conditions
Time frame: 60 minutes
EEG relative power in the beta band
brain activity under single, motor dual-task, and cognitive dual-task walking conditions
Time frame: 60 minutes
EEG relative power in the low gamma band
brain activity under single, motor dual-task, and cognitive dual-task walking conditions
Time frame: 60 minutes
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