Rosenfeldt Anson B, Streicher Matthew C, Kaya Ryan D, Penko Amanda L, Zimmerman Eric M, Liao James Y, Walter Benjamin L, Alberts Jay L
Cleveland Clinic, Lerner Research Institute, Department of Biomedical Engineering, 9500 Euclid Ave, Cleveland, OH 44195, USA.
Cleveland Clinic, Neurological Institute, Center for Neurological Restoration, 9500 Euclid Ave, Cleveland, OH 44195, USA.
Gait Posture. 2025 Jan;115:102-108. doi: 10.1016/j.gaitpost.2024.11.007. Epub 2024 Nov 14.
The Dual-task Augmented Reality Treatment (DART) trial recently established that dual-task training (DTT) delivered by a physical therapist or the augmented reality DART platform was effective in improving spatiotemporal gait parameters under single- and dual-task conditions in individuals with Parkinson's disease (PD). Data regarding postural stability were not reported in the primary outcome manuscript.
The aim of this secondary analysis was to compare the effects of a Traditional DTT intervention delivered by a physical therapist and DTT delivered by the DART platform on postural stability, functional mobility, and turning in individuals with PD. It was hypothesized that both groups would experience similar improvements.
Forty-seven individuals with PD were randomized to an 8-week (16 sessions) Traditional DTT or DART intervention. The limits of stability test and the instrumented Timed Up and Go (TUG) under single- and dual-task conditions were gathered at Baseline, End of Treatment (EOT), and 8-weeks after EOT.
At EOT, the Traditional DTT and DART groups experienced a 9 % and 14 % improvement in maximal excursion area and a 7 % and 12 % improvement in total TUG time under dual-task conditions, respectively (p<0.05). Turn duration and average and peak turn velocity during the TUG improved for both groups under single- and dual-task conditions at EOT. Improvements in turn duration (dual-task) and average turn velocity (single- and dual-task) persisted 8-weeks after intervention cessation.
Improvements in postural stability, functional mobility, and turning under single- and dual-task conditions following traditional and DART DTT in individuals with PD indicate that cognitive-motor training can be used to effectively treat postural instability in this population. Improvements in the DART group were similar to traditional DTT, supporting our previous data demontrating that DART is an effective digital therapeutic to improve gait and postural instability in individuals with PD.
双任务增强现实治疗(DART)试验最近证实,由物理治疗师或增强现实DART平台提供的双任务训练(DTT),在改善帕金森病(PD)患者单任务和双任务条件下的时空步态参数方面是有效的。主要结果手稿中未报告有关姿势稳定性的数据。
本二次分析的目的是比较物理治疗师提供的传统DTT干预与DART平台提供的DTT对PD患者姿势稳定性、功能移动性和转身能力的影响。假设两组将经历相似的改善。
47名PD患者被随机分配到为期8周(16节)的传统DTT或DART干预组。在基线、治疗结束(EOT)时以及EOT后8周收集单任务和双任务条件下的稳定性测试极限和仪器化定时起立行走测试(TUG)数据。
在EOT时,传统DTT组和DART组在双任务条件下的最大偏移面积分别改善了9%和14%,总TUG时间分别改善了7%和12%(p<0.05)。在EOT时,两组在单任务和双任务条件下的TUG过程中的转身持续时间、平均转身速度和峰值转身速度均有所改善。干预停止8周后,转身持续时间(双任务)和平均转身速度(单任务和双任务)的改善仍然存在。
PD患者在接受传统和DART DTT后,在单任务和双任务条件下姿势稳定性、功能移动性和转身能力的改善表明,认知运动训练可有效治疗该人群的姿势不稳。DART组的改善与传统DTT相似,支持我们之前的数据表明DART是一种有效的数字疗法,可改善PD患者的步态和姿势不稳。