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Effects of dual-task group training on gait, cognitive executive function and quality of life in people with Parkinson's disease: results of randomized controlled DUALGAIT trial [with consumer summary]
San Martin Valenzuela C, Moscardo LD, Pascual JL, Ano PS, Tomas JM
Archives of Physical Medicine and Rehabilitation 2020 Nov;101(11):1849-1856
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: This study aims (1) to analyze the effects of a dual-task group program, (2) to compare it with the effects of a single-task group program and, (3) to analyze the effects of functional secondary tasks. DESIGN: Single-blind randomized controlled trial. SETTING: University laboratory, rehabilitation gym at health center. PARTICIPANTS: People (N = 40) with a diagnosis of Parkinson's disease (aged 66.72 (44 to 79) years, Hoehn and Yahr stage I-II-III and on-medication) were randomized to (1) a group with dual-task training or (2) a group with single-task training (only gait). INTERVENTION: Both interventions involved 20 one-hour sessions conducted twice a week. Dual-task training included walking exercises and cognitive or motor tasks carried out separately, later performed together as a dual-task according to a progressive protocol in the same training session. MAIN OUTCOME MEASURES: Velocity and spatiotemporal parameters of gait were measured without a secondary task and during dual-task gait combined with a visual, verbal, auditory and motor task. In addition, Executive cognitive function and Quality of life were measured. Assessment were conducted at baseline, post-rehabilitation, and at 8-weeks follow-up. RESULTS: Dual-task group improved velocity, and stride length time in all assessment conditions after training (p < 0.05), like their perceived quality of life (p < 0.05). Single-task group experienced improvements in the same outcomes only for the motor condition (p < 0.05) after training, but failed to improve perceived quality of life (p > 0.05). Likewise, the dual-task group showed higher velocity and stride length after treatment than the single-task group across conditions. No significant changes in cognitive performance were observed (p > 0.05), although DT group tended to improve performance during the executive function test. CONCLUSIONS: Dual tasks training in functional contexts is associated with greater improvements in velocity and stride length in patients with PD as compared to regular physiotherapy without secondary tasks, and improves perceived quality of life.

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