Short-Term Effects of Single-Session Split-Belt Treadmill Training on Dual-Task Performance in Parkinson's Disease and Healthy Elderly
Background: Dual-tasking is challenging for people with Parkinson's disease and freezing of gait (PD+FOG) and can exacerbate freezing episodes and falls. Split-belt treadmill training (SBT) is a novel tool to train complex gait and may improve dual-task (DT) walking and turning.Objective: To in...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.560084/full |
| _version_ | 1828961294075559936 |
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| author | Nicholas D'Cruz Jana Seuthe Pieter Ginis Femke Hulzinga Christian Schlenstedt Alice Nieuwboer |
| author_facet | Nicholas D'Cruz Jana Seuthe Pieter Ginis Femke Hulzinga Christian Schlenstedt Alice Nieuwboer |
| author_sort | Nicholas D'Cruz |
| collection | DOAJ |
| description | Background: Dual-tasking is challenging for people with Parkinson's disease and freezing of gait (PD+FOG) and can exacerbate freezing episodes and falls. Split-belt treadmill training (SBT) is a novel tool to train complex gait and may improve dual-task (DT) walking and turning.Objective: To investigate the single-session effects of SBT on DT walking and DT turning performance in PD+FOG and older adults (OA), compared to regular treadmill training.Methods: Forty-five PD+FOG and 36 OA participated in a single training session (30 min). They were randomized into one of four training groups: (A) SB75—steady belt speed ratio 0.75:1; (B) SB50—steady belt speed ratio 0.5:1; (C) SBCR—changing belt speed ratios between 0.75:1 and 0.5:1; and (D) Tied-Belt (TBT). Over-ground straight-line gait and an alternating turning in place task combined with a cognitive dual-task (DT) (auditory Stroop) were assessed pre- and post-training, and the following day (retention). Constrained longitudinal data analysis was used to investigate the training effects for all participants and for PD+FOG alone.Results: DT gait speed improved at post-training for all groups (p < 0.001). However, SBT (SB50 and SBCR) led to larger post-training improvements compared to TBT, which were still visible at retention (SB50). For mean DT turning speed and Stroop response time while walking, only SBT groups showed significant improvements at post-training or retention. DT stride length, peak DT turning speed, and Stroop performance index while walking also showed larger gains in SBT compared to TBT. Results for PD+FOG alone showed similar effects although with smaller effect sizes.Conclusions: A single session of SBT in PD+FOG and OA showed larger short-term effects on DT walking and turning compared to TBT. Cognitive DT performance was also improved in SBT, likely due to reduced cortical control of gait. These results illustrate the potential for SBT to improve DT during complex gait and possibly reduce fall risk in clinical and healthy populations. |
| first_indexed | 2024-12-14T09:43:57Z |
| format | Article |
| id | doaj.art-adf98d37635d4243bfadb5542aa7b06a |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-14T09:43:57Z |
| publishDate | 2020-09-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-adf98d37635d4243bfadb5542aa7b06a2022-12-21T23:07:43ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-09-011110.3389/fneur.2020.560084560084Short-Term Effects of Single-Session Split-Belt Treadmill Training on Dual-Task Performance in Parkinson's Disease and Healthy ElderlyNicholas D'Cruz0Jana Seuthe1Pieter Ginis2Femke Hulzinga3Christian Schlenstedt4Alice Nieuwboer5Neurorehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, BelgiumDepartment of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University (CAU) Kiel, Kiel, GermanyNeurorehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, BelgiumNeurorehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, BelgiumDepartment of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University (CAU) Kiel, Kiel, GermanyNeurorehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, BelgiumBackground: Dual-tasking is challenging for people with Parkinson's disease and freezing of gait (PD+FOG) and can exacerbate freezing episodes and falls. Split-belt treadmill training (SBT) is a novel tool to train complex gait and may improve dual-task (DT) walking and turning.Objective: To investigate the single-session effects of SBT on DT walking and DT turning performance in PD+FOG and older adults (OA), compared to regular treadmill training.Methods: Forty-five PD+FOG and 36 OA participated in a single training session (30 min). They were randomized into one of four training groups: (A) SB75—steady belt speed ratio 0.75:1; (B) SB50—steady belt speed ratio 0.5:1; (C) SBCR—changing belt speed ratios between 0.75:1 and 0.5:1; and (D) Tied-Belt (TBT). Over-ground straight-line gait and an alternating turning in place task combined with a cognitive dual-task (DT) (auditory Stroop) were assessed pre- and post-training, and the following day (retention). Constrained longitudinal data analysis was used to investigate the training effects for all participants and for PD+FOG alone.Results: DT gait speed improved at post-training for all groups (p < 0.001). However, SBT (SB50 and SBCR) led to larger post-training improvements compared to TBT, which were still visible at retention (SB50). For mean DT turning speed and Stroop response time while walking, only SBT groups showed significant improvements at post-training or retention. DT stride length, peak DT turning speed, and Stroop performance index while walking also showed larger gains in SBT compared to TBT. Results for PD+FOG alone showed similar effects although with smaller effect sizes.Conclusions: A single session of SBT in PD+FOG and OA showed larger short-term effects on DT walking and turning compared to TBT. Cognitive DT performance was also improved in SBT, likely due to reduced cortical control of gait. These results illustrate the potential for SBT to improve DT during complex gait and possibly reduce fall risk in clinical and healthy populations.https://www.frontiersin.org/article/10.3389/fneur.2020.560084/fulldual-taskinggait trainingrehabilitationfreezing of gaitturning in placeconstrained longitudinal data analysis |
| spellingShingle | Nicholas D'Cruz Jana Seuthe Pieter Ginis Femke Hulzinga Christian Schlenstedt Alice Nieuwboer Short-Term Effects of Single-Session Split-Belt Treadmill Training on Dual-Task Performance in Parkinson's Disease and Healthy Elderly Frontiers in Neurology dual-tasking gait training rehabilitation freezing of gait turning in place constrained longitudinal data analysis |
| title | Short-Term Effects of Single-Session Split-Belt Treadmill Training on Dual-Task Performance in Parkinson's Disease and Healthy Elderly |
| title_full | Short-Term Effects of Single-Session Split-Belt Treadmill Training on Dual-Task Performance in Parkinson's Disease and Healthy Elderly |
| title_fullStr | Short-Term Effects of Single-Session Split-Belt Treadmill Training on Dual-Task Performance in Parkinson's Disease and Healthy Elderly |
| title_full_unstemmed | Short-Term Effects of Single-Session Split-Belt Treadmill Training on Dual-Task Performance in Parkinson's Disease and Healthy Elderly |
| title_short | Short-Term Effects of Single-Session Split-Belt Treadmill Training on Dual-Task Performance in Parkinson's Disease and Healthy Elderly |
| title_sort | short term effects of single session split belt treadmill training on dual task performance in parkinson s disease and healthy elderly |
| topic | dual-tasking gait training rehabilitation freezing of gait turning in place constrained longitudinal data analysis |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.560084/full |
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