Objective: To determine the feasibility and preliminary efficacy of a home-based, technological visuo-cognitive training (TVT) intervention using a mobile application and exercise with stroboscopic glasses compared to standard care in people with Parkinson’s disease (PD).

Background: There is currently no pharmacological treatment for visuo-cognitive impairments in PD. Alternative strategies are needed to address these non-motor symptoms given their impact on quality of life. Novel technologies have potential to deliver multimodal rehabilitation of visuo-cognitive dysfunction, but more research is required to determine their feasibility in PD [1].

Method: This pilot randomised controlled trial followed a parallel group design. Participants were allocated to one of two active interventions, TVT (n=20) or standard care (SC) (n=20). They received 8 sessions of training in their own homes with a physiotherapist. The TVT consisted of cognitive training drills via a mobile application and exercises with stroboscopic glasses. The SC intervention consisted of pen and paper cognitive tasks and exercises under normal visual conditions. Outcomes were collected at baseline and after four weeks of intervention. Primary outcomes were feasibility of the study design and intervention. Exploratory outcomes included cognitive assessments, mobility, and gait tests and measures of visual function.

Results: 40 people with PD (age 69.4±9.2yrs; Hoehn & Yahr stage 2.1±0.7; disease duration 6.5±6.1yrs; UPDRS III 33.4±16.4 points; MoCA 26.6±2.7 points) were recruited. The recruitment rate was 60% (40/67), and the retention rate was 98% (39/40). Adherence to both arms of the intervention was high, with participants attending 98% of visits in the TVT group and 96% of visits in the SC group. There were significant improvements with medium effect sizes in both groups when comparing pre and post values for cognition (executive function) (TMT B, TVT p=0.013, SC p=0.011) and functional mobility (Mini-BESTest, TVT p=0.006, SC p=0.007).  Gait parameters also improved within each group, although not significantly. No between group differences were observed.

Conclusion: Our findings suggests that home-based TVT with a physiotherapist is feasible in people with PD and could provide a novel approach to addressing cognitive and motor dysfunction in this population.

References: Das J, Morris R, Barry G, Vitorio R, Oman P, McDonald C, et al. (2022) Exploring the feasibility of technological visuo-cognitive training in Parkinson’s: Study protocol for a pilot randomised controlled trial. PLoS ONE 17(10): e0275738. https://doi.org/10.1371/journal.pone.0275738

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MDS Abstracts - https://www.mdsabstracts.org/abstract/technological-visuo-cognitive-training-in-parkinsons-disease-preliminary-findings-from-a-pilot-randomised-controlled-trial/