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The Adapted Resistance Training with Instability Randomized Controlled Trial for Gait Automaticity.

Bianca Vieira-Yano1,2, Douglas N Martini3, Fay B Horak3

  • 1Exercise Neuroscience Research Group, University of Sao Paulo, Sao Paulo, Brazil.

Movement Disorders : Official Journal of the Movement Disorder Society
|September 21, 2020
PubMed
Summary

Adapted resistance training with instability (ARTI) improved gait automaticity and attentional set-shifting in Parkinson's disease patients with freezing of gait. ARTI was more effective than traditional rehabilitation, showing significant improvements in dual-task gait parameters and cerebellar locomotor region activation.

Keywords:
Freezers; dual-task cost; cerebellar locomotor region; attentional control; motor complexity

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Movement Disorders

Background:

  • Freezing of gait (FOG) in Parkinson's disease is linked to cerebellar locomotor region (CLR) deficits, impacting gait automaticity.
  • Existing exercise interventions often lack effectiveness in restoring gait automaticity for FOG patients.
  • The study investigates a novel exercise approach to address these limitations.

Purpose of the Study:

  • To evaluate the efficacy of adapted resistance training with instability (ARTI) versus traditional motor rehabilitation on gait automaticity and attentional set-shifting in FOG patients.
  • To explore the relationship between changes in gait automaticity and CLR activation post-intervention.

Main Methods:

  • Randomized trial comparing ARTI (complex exercises) with traditional motor rehabilitation over 12 weeks.
  • Evaluated gait automaticity (dual-task cost on speed and stride length), single-task gait, and attentional set-shifting (Trail Making Test B-A).
  • Assessed CLR activation using functional MRI during a simulated step initiation task.

Main Results:

  • Both groups improved single-task gait, but ARTI significantly enhanced dual-task gait parameters (reduced dual-task cost) and CLR activation.
  • ARTI demonstrated a significant association between improved CLR activation and reduced dual-task stride length cost.
  • Only the ARTI group showed significant improvements in attentional set-shifting post-intervention.

Conclusions:

  • Adapted resistance training with instability (ARTI) effectively restores gait automaticity in Parkinson's disease patients with freezing of gait.
  • The complex exercises within ARTI are attributed to improvements in gait automaticity and attentional set-shifting.
  • ARTI represents a promising therapeutic strategy for improving motor and cognitive functions in FOG.