Objective: To investigate the effects of complex walking training and motor-cognitive training on obstacle-crossing ability in Parkinson’s disease (PD).

Background: Obstacle crossing needs both motor and cognition function, which is a daily task during community ambulation [1]. People with PD mostly demonstrate motor impairments, but some people also demonstrate cognitive involvement which leads to increasing fall risks during obstacle crossing [2]. However, effective training to improve obstacle-crossing ability is lacking. We proposed two innovative exercises, complex walking training and motor-cognitive training to improve obstacle crossing ability in people with PD.

Method: Twenty-nine participants with diagnosis of PD were randomly assigned to the complex walking training group (n=9), motor-cognitive training group (n=10), or control group (n=10). Training groups received exercises for 40 minutes per session, with a total of 12 sessions over 4 to 6 weeks. Control group only maintained the daily activities. Primary outcomes included obstacle-crossing performance (velocity, stride length, and step width) and obstacle walking performance (gait speed, stride length, and cadence). Secondary outcomes included cognitive function in different domains, usual walking performance, timed up and go test (TUG), fall efficacy scale (FES-I), and Parkinson’s Disease Questionnaire (PDQ-39).

Results: Motor-cognitive training group showed greater improvements in obstacle crossing stride length, crossing velocity, obstacle walking speed, obstacle walking stride length, digit span test, usual walking performance, and TUG than the control group. Complex walking training showed greater improvements in Rey-Osterrieth Complex Figure test and TUG than the control group. Besides, the improvement in Rey-Osterrieth Complex Figure test was significantly more after complex walking training than motor-cognitive training (p= 0.043).

Conclusion: Motor-cognitive training significantly improved obstacle crossing performance, obstacle walking, digit span, single walking, and TUG. While complex walking training improved cognitive visual-spatial ability and TUG. Therefore, different training programs should be adopted accordingly in PD rehabilitation.

References: 1. Mirelman, A., et al., Effects of aging on prefrontal brain activation during challenging walking conditions. Brain Cogn, 2017. 115: p. 41-46.
2. Galna, B., A.T. Murphy, and M.E. Morris, Obstacle crossing in people with Parkinson’s disease: foot clearance and spatiotemporal deficits. Hum Mov Sci, 2010. 29(5): p. 843-52.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-motor-and-cognitive-complex-training-on-obstacle-crossing-ability-in-participants-with-parkinsons-disease/