Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo , São Paulo, Brazil.
Universidade Federal de São Paulo , Brazil.
Physiother Theory Pract. 2020 Oct;36(10):1088-1096. doi: 10.1080/09593985.2018.1551455. Epub 2018 Dec 3.
In patients with Parkinson's disease (PD), the ability to perform simultaneous tasks may be impaired. However, there is no consensus as to whether the strategy of use dual task (DT) should be used with PD patients during gait and balance training because DT can increase the risk of falls. Therefore, it is necessary to critically analyze the relevant studies and evaluate the indications for the use of DT and its effects as a therapeutic strategy. The aim of this systematic review was to explore the effects of DT gait and balance training in individuals with PD. A total of 602 studies were found. After applying the eligibility criteria, seven studies were selected (three clinical trials, one uncontrolled clinical trial, and three pilot studies). Despite the poor methodological quality, the studies indicated the use of DT during gait and balance training may be beneficial for people with mild to moderate PD in compare of single-task or no intervention. The use of DT during training presented benefits related to gait (gait speed, step length and cadence) and balance (mediolateral and anteroposterior balance in closed-eyes tests). The current scenario shows that using DT in the training seems not to be harmful and could be part of the rehabilitation of PD patients. Further clinical trials are needed to confirm the findings, and it would be the most importance that these studies stratify individuals with degrees of disease severity to verify the effect of using the DT during training.
在帕金森病（PD）患者中，同时执行任务的能力可能会受损。然而，目前尚无共识认为在步态和平衡训练中是否应采用双重任务（DT）策略，因为 DT 会增加跌倒的风险。因此，有必要对相关研究进行批判性分析，并评估 DT 的使用指征及其作为治疗策略的效果。本系统评价旨在探讨 DT 步态和平衡训练对 PD 患者的影响。共发现 602 项研究。在应用纳入标准后，选择了 7 项研究（3 项临床试验、1 项非对照临床试验和 3 项试点研究）。尽管方法学质量较差，但这些研究表明，与单任务或无干预相比，在步态和平衡训练期间使用 DT 可能对轻度至中度 PD 患者有益。在训练期间使用 DT 与步态（步速、步长和步频）和平衡（闭眼测试中的横向和前后向平衡）相关的益处。目前的情况表明，在训练中使用 DT 似乎没有危害，并且可能是 PD 患者康复的一部分。需要进一步的临床试验来证实这些发现，最重要的是，这些研究应根据疾病严重程度对个体进行分层，以验证在训练中使用 DT 的效果。
