Affiliations: Clinical Research Unit, Clalit Health Services, Haifa and Western Galilee District, Israel | Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel | Lin Medical Center and Clalit Medical Services, Haifa, Israel | Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel | Department of Physical Therapy, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel | Department of Medicine, Harvard Medical School, Boston, MA, USA
Note: [] Correspondence to: Jeffrey M. Hausdorff, PhD, Laboratory for Gait Analysis & Neurodynamics, Movement Disorders Unit, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel. Fax: +972 3 697 4911; E-mail: jhausdor@tlvmc.gov.il
Abstract: Background: Patients with Parkinson's disease (PD) suffer from impaired gait and mobility. These changes in motor function have been associated with cognitive deficits that also commonly co-occur in PD, especially executive function (EF) and attention. Objective: We hypothesized that a cognitive remediation program would enhance gait and mobility. Methods: The 18 PD patients in this study were assessed at baseline and again one and four weeks after completion of a 12 week long, home-based computerized cognitive training program. Subjects were asked to “play” computer games designed to improve EF and attention for 30 minutes a day, three times per week for 12 weeks, while seated. The Timed Up and Go (TUG), gait speed, and stride time variability quantified mobility. A previously validated, computerized neuropsychological battery quantified global cognitive function and its sub-domains. Results: Compared to pre-training values, global cognitive scores and time to complete the TUG significantly improved after the training. TUG components of turning speed and duration also improved. Other TUG components, gait speed, and variability did not change after training. Conclusions: These initial findings suggest that computerized cognitive training can improve cognitive function and has a beneficial carryover effect to certain aspects of mobility in patients with PD. Additional studies are required to replicate these findings and more fully assess the underlying mechanisms. Nonetheless, the present results underscore the motor-cognitive link in PD and suggest that computerized cognitive training may be applied as a therapeutic option to enhance mobility in patients with PD.
Keywords: Cognitive training, gait, mobility, cognitive function, Parkinson's disease, attention, executive function, instrumented Timed Up and Go, body-fixed sensor
