Session Time: 1:45pm-3:15pm
Location: Agora 3 West, Level 3
Objective: To investigate the effects of a 6-week cognitively challenging exercise intervention in people with Parkinson’s disease (PD).
Background: Gait and balance impairments have been associated with cognitive deficits in people with PD. We designed an Agility Boot Camp with Cognitive challenges (ABC-C) rehabilitation program to see if improvements could be made in balance, gait, and cognition(1).
Method: In this cross-over design, 94 people with PD (age 68±7 years, MDS-UPDRS III, Off medication 42±12; mean±SD), including 40 with freezing of gait (FoG), completed 6-weeks of ABC-C exercise program and 6-weeks of education classes (placebo), with the order of interventions randomized. Outcome measures (Off medication) included clinical, perceived, objective measures of balance and gait (single- and dual-task), and cognitive function. We used a linear mixed-model that included fixed effects (treatment and order) and random effects (subjects).
Results: Postural instability and gait disorder (PIGD) score improved after ABC-C program but not after education (p=0.002), while the MDS-UPDRS III (p=0.25) and total Mini-BESTest (p=0.08) did not change. For subjects with FoG, though, worse baseline Motor UPDRS (>67 Off) and Mini-BESTest (<20) scores showed significant improvement (p=.01-.04). Perceived functional independence showed a significant improvement (PDQ39, p=0.001; MDS-UPDRS II, p=0.01). Among gait and balance measures, the spatio-temporal gait parameters significantly improved after the ABC-C program but not after education (p<0.00001). Postural sway with eyes open on foam improved after the ABC-C program but not after education (p=0.03), while postural responses to a Push and Release test did not change. Executive function measured with the SCOPA-COG was not different after ABC-C and education (p=0.06). However, a significant improvement in SCOPA-COG was observed after ABC-C in those participants with longer disease duration (p=0.009). Lastly, dual-task cost on gait speed significantly improved after ABC-C program but not after education (p=0.001).
Conclusion: A 6-week cognitively challenging exercise program improved specific characteristics of gait and balance in a large group of patients with PD. Spatio-temporal parameters of gait, dual-task cost of gait, perceived functional independence, and PIGD were the most sensitive to change after exercise compared to after education.
References: 1) King et al. Do cognitive measures and brain circuitry predict outcomes of exercise in Parkinson Disease: a randomized clinical trial, BMC Neurology 15:218, 2015
To cite this abstract in AMA style:P. Carlson-Kuhta, N. Hasegawa, SH. Jung, V. Shah, A. Ragothaman, D. Peterson, K. Smulders, L. King, M. Mancini, J. Lapidus, J. Nutt, F. Horak. Effects of Cognitively Challenging Agility Exercise Program on Clinical and Objective Measures in People with Parkinson’s Disease [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/effects-of-cognitively-challenging-agility-exercise-program-on-clinical-and-objective-measures-in-people-with-parkinsons-disease/. Accessed December 7, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-cognitively-challenging-agility-exercise-program-on-clinical-and-objective-measures-in-people-with-parkinsons-disease/