Associations between baseline cognitive status and motor outcomes after treadmill training in people with Parkinson's disease: a pilot study.
Associations between baseline cognitive status and motor outcomes after treadmill training in people with Parkinson's disease: a pilot study.
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帕金森病患者跑步机训练后基线认知状态与运动结果之间的关联：一项试点研究。
DOI：
10.1080/09638288.2023.2189318
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发表时间：
2024
影响因子：
2.2
通讯作者：
Kelly,ValerieE
中科院分区：
文献类型：
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作者：
Amin,RaimaM;Phillips,JamesJ;Humbert,AndrewT;Cholerton,BrennaA;Short,ValerieD;Smith,MelissaJ;Zabetian,CyrusP;Mata,IgnacioF;Kelly,ValerieE
目的 确定帕金森病 (PD) 患者在跑步机训练计划后基线认知对步态结果的影响。方法这项试点临床试验涉及被归类为无认知障碍 (PD-NCI) 或轻度认知障碍 (PD-MCI) 的帕金森病患者。评估基线执行功能和记忆力。干预措施是为期 10 周的步态训练计划（每周两次跑步机训练），包括结构化的速度和距离进展以及步态质量的口头提示。通过第 2 周（短期）和第 10 周（长期）后测量的步态速度来评估对干预的反应。 结果参与者（n= 19；12 名 PD-NCI，7 名 PD-MCI）的平均（标准差）年龄为 66.5 (6.3) 岁，疾病持续时间为 8.8 (6.3) 年，MDS-UPDRS III 评分为 21.3 （10.7）。短期和长期评估的步态速度都有所提高。 PD-NCI 组和 PD-MCI 组之间的反应没有差异；然而，在未调整和调整模型中，更好的基线记忆表现和较轻的帕金森运动严重程度与步态速度的更大改善独立相关。结论这些发现表明，记忆障碍和更严重的运动参与可以影响帕金森病步态康复的反应，并强调需要针对认知和运动障碍较重的人进行优化治疗。对康复的影响帕金森病（PD）的认知缺陷可能会影响运动学习和步态康复，但对其影响知之甚少。认知障碍对帕金森病患者康复反应的影响。这项研究表明，没有认知障碍的帕金森病患者和有轻度认知障碍的帕金森病患者对步态康复的反应没有差异。在所有参与者中，更好的基线记忆与步态速度的更大改善有关。康复专业人员应注意帕金森病的严重程度，因为那些记忆和运动障碍较严重的人可能需要额外的剂量或支持，以最大限度地发挥步态训练的益处。
PurposeTo determine the effect of baseline cognition on gait outcomes after a treadmill training program for people with Parkinson’s disease (PD).MethodsThis pilot clinical trial involved people with PD who were classified as having no cognitive impairment (PD-NCI) or mild cognitive impairment (PD-MCI). Baseline executive function and memory were assessed. The intervention was a 10-week gait training program (twice-weekly treadmill sessions), with structured speed and distance progression and verbal cues for gait quality. Response to intervention was assessed by gait speed measured after week 2 (short-term) and week 10 (long-term).ResultsParticipants (n= 19; 12 PD-NCI, 7 PD-MCI) had a mean (standard deviation) age of 66.5 (6.3) years, disease duration of 8.8 (6.3) years, and MDS-UPDRS III score of 21.3 (10.7). Gait speed increased at short-term and long-term assessments. The response did not differ between PD-NCI and PD-MCI groups; however, better baseline memory performance and milder PD motor severity were independently associated with greater improvements in gait speed in unadjusted and adjusted models.ConclusionsThese findings suggest that memory impairments and more severe motor involvement can influence the response to gait rehabilitation in PD and highlight the need for treatments optimized for people with greater cognitive and motor impairment.IMPLICATIONS FOR REHABILITATIONCognitive deficits in Parkinson’s disease (PD) could impact motor learning and gait rehabilitation, yet little is known about the effects of cognitive impairments on the response to rehabilitation in people with PD.This study demonstrates that the response to gait rehabilitation did not differ between people with PD who had no cognitive impairment and those with mild cognitive impairment.Across all participants, better baseline memory was associated with greater improvements in gait speed.Rehabilitation professionals should be mindful of PD severity, as those with more substantial memory and motor impairments may require additional dosing or support to maximize gait training benefits.