An augmented reality dual-task intervention improves postural stability in individuals with Parkinson's disease

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.