Abstract
Reactive stepping is impaired in people with Parkinson's Disease (PD) but can be improved with training. However, it is unclear if reactive steps can be improved when performing a concurrent cognitive task, a common and fall-relevant circumstance. We assessed the feasibility and preliminary effectiveness of dual-task reactive step training. Specifically, we measured whether stepping and cognitive reaction time are improved after one day of dual-task reactive step practice and if improvements are retained 24 h later. Sixteen people with PD and 13 age-matched healthy controls (HC) underwent repeated from-stance support surface perturbations that elicited a reactive step while performing an auditory Stroop task. Participants returned the following day to reassess dual-task reactive stepping performance. Cognitive, neuromuscular, and stepping outcomes were calculated. Increased step lengths were observed for both groups after practice (p < 0.001). Cognitive reaction times also improved through practice; however, this was more pronounced in the HC group (group by time interaction- p < 0.001). No changes were observed for step latency, margin of stability, or EMG onset through practice. Step length and cognitive reaction time improvements were retained 24 h after practice in both groups (step length: p < 0.001; cognitive reaction time: p = 0.05). This study provides preliminary evidence for the effectiveness of dual-task reactive step training to improve step length in people with PD. The improvements in step length without compromising cognitive reaction times suggest that participants improved reactive stepping without a robust attention shift toward the postural task. Future research is necessary to determine optimal training protocols and determine if such training protocols impact falls in PD patients.
Original language | English (US) |
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Article number | 102876 |
Journal | Human Movement Science |
Volume | 80 |
DOIs | |
State | Published - Dec 2021 |
Keywords
- Automatic postural responses
- Dual-tasking
- Falls
- Parkinson's disease
- Protective stepping
ASJC Scopus subject areas
- Biophysics
- Orthopedics and Sports Medicine
- Experimental and Cognitive Psychology