Elisa Pelosin, Chiara Ponte, Martina Putzolu, Giovanna Lagravinese, Jeffrey M Hausdorff, Alice Nieuwboer, Pieter Ginis, Lynn Rochester, Lisa Alcock, Bastiaan R Bloem, Freek Nieuwhof, Andrea Cereatti, Ugo Della Croce, Anat Mirelman, Laura Avanzino
Background:
The use of virtual reality in treadmill training (VR-TT) has demonstrated positive effects on enhancing gait performance and decreasing the risk of falls in individuals with Parkinson’s disease (PD). Nonetheless, there is currently no agreement regarding the most effective duration for this training.
Objective:
This research is a subset of the V-TIME randomized clinical trial (NCT01732653). This motor-cognitive treadmill training study examines how the duration of training, specifically focusing on the interaction between motor and cognitive abilities, affects the motor and cognitive performance, as well as the risk of falls, in individuals with PD.
Subjects:
The study included patients in Hoehn and Yahr stages II-III, aged between 40 and 70 years.
Method:
A total of 96 PD patients were divided into two groups: one receiving treadmill training with virtual reality (TT + VR) for 6 weeks and the other for 12 weeks. Of these patients, 77 successfully completed the entire treatment plan as outlined.
Evaluations of gait and cognitive performance were conducted at the beginning, immediately after training, and at 1- and 6-month follow-up intervals. The occurrence of falls during the 6 months prior to the intervention was compared to the rate of falls during the 6 months following the intervention.
Results:
Following motor-cognitive treadmill training, both groups demonstrated similar improvements in dual-task gait performance, including gait speed, gait speed variability, stride length during cognitive dual tasks, obstacle negotiation, and leading foot clearance in obstacle negotiation. These gains were maintained at the 6-month follow-up assessment.
Participants undergoing the 12-week motor-cognitive treadmill training intervention experienced a greater reduction in the rate of falls and fear of falling compared to those in the 6-week intervention. However, improvements in cognitive functions, such as executive functions, visuospatial ability, and attention, were only observed in participants who completed the 12-week motor-cognitive treadmill training, up to the 1-month follow-up, but these improvements diminished by the 6-month evaluation.
Conclusions:
The study findings indicate that a more extended duration of treadmill training with virtual reality (TT + VR) results in greater improvements in cognitive functions, particularly those that are specifically targeted and engaged within the virtual environment.
GaitBetter is the commercial implementation of the V-TIME academic research project that yield many of these papers.