Silva-Batista Carla, Almeida Filipe Oliveira de, Batista Alana, Barbosa Egberto Reis, Horak Fay B, Ugrinowitsch Carlos
Exercise Neuroscience Research Group, University of São Paulo, SP, Brazil.
Laboratory of Neuromuscular Adaptations to Strength Training, School of Physical Education and Sport, University of São Paulo, SP, Brazil.
Neurorehabil Neural Repair. 2025 Jan;39(1):3-15. doi: 10.1177/15459683241290793. Epub 2024 Oct 15.
Evidence has suggested that cognitive decline may be a risk factor for freezing of gait (FOG) in Parkinson's disease (PD). Complex and challenging exercises have been suggested as potential rehabilitation strategies to decrease FOG severity and improve cognition; however, it is unknown whether improvement in cognition would explain decreased FOG severity following exercise.
In this secondary analysis, we evaluated the effects of the adapted resistance training with instability (ARTI-complex and challenging exercises) compared with traditional motor rehabilitation (TMR-without challenging exercises) on cognitive function in people with FOG of PD. We also verified whether cognitive improvement explains the decrease in FOG previously published.
Participants were randomized to either the experimental group (ARTI, n = 17) or the active control group (TMR, n = 15). Both training groups exercised 3 times a week for 12 weeks (80-90 minute each session). FOG severity (FOG ratio from inertial sensors during a 360° turning-in-place task), frontal lobe function (Frontal Assessment Battery [FAB]), global cognition (Montreal Cognitive Assessment [MoCA]), and attention and psychomotor speed (Digit Symbol Substitution Test [DSST]) were evaluated before and after interventions.
Only the ARTI group improved FAB, MoCA, and DSST scores at posttraining. In addition, ARTI was more effective than TMR in improving FAB scores at posttraining. The changes in FAB scores explained the changes in FOG ratio following ARTI ( = .43, < .01).
This pilot study suggests that ARTI, a complex and challenging training, improves cognition in people with FOG of PD. Improvements in frontal lobe function with ARTI help explain decreased FOG severity.
有证据表明，认知功能下降可能是帕金森病（PD）患者步态冻结（FOG）的一个风险因素。复杂且具有挑战性的运动已被提议作为降低FOG严重程度和改善认知的潜在康复策略；然而，认知功能的改善是否能解释运动后FOG严重程度的降低尚不清楚。
在这项二次分析中，我们评估了与传统运动康复（TMR，无挑战性运动）相比，适应性不稳定抗阻训练（ARTI，复杂且具有挑战性的运动）对PD伴FOG患者认知功能的影响。我们还验证了认知功能的改善是否能解释之前发表的FOG严重程度的降低。
参与者被随机分为实验组（ARTI，n = 17）或活性对照组（TMR，n = 15）。两个训练组每周锻炼3次，共12周（每次训练80 - 90分钟）。在干预前后评估FOG严重程度（360°原地转身任务中惯性传感器的FOG比率）、额叶功能（额叶评估量表 [FAB]）、整体认知（蒙特利尔认知评估量表 [MoCA]）以及注意力和心理运动速度（数字符号替换测验 [DSST]）。
仅ARTI组在训练后FAB、MoCA和DSST评分有所改善。此外，在训练后ARTI在改善FAB评分方面比TMR更有效。FAB评分的变化解释了ARTI后FOG比率的变化（r = 0.43，p < 0.01）。
这项初步研究表明，ARTI这种复杂且具有挑战性的训练可改善PD伴FOG患者的认知功能。ARTI带来的额叶功能改善有助于解释FOG严重程度的降低。
