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The effect of tactile cueing on dual task performance in Parkinson's disease. A systematic review and meta-analysis
Viktoria Azoidou1, Alastair J Noyce1,2, Cristina Simonet1,3
1Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Background:
Dual-task (DT) performance is impaired in Parkinson's disease (PD), contributing to bradykinesia, postural instability, freezing of gait, and falls. Tactile cueing, including vibrotactile stimulation, has been suggested to improve DT performance in PD.
Research Question:
Does tactile cueing affect DT performance in PD, specifically measured by dual-task cost (DTC)?
Methods:
A systematic review was conducted in PubMed and EMBASE up to October 30, 2023, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were those in English that examined the effects of tactile cueing and/or closed-loop vibrotactile stimulation on DT performance in adults over 18 with idiopathic PD. The primary outcome, DTC, was calculated as the percentage change in performance from DT to single-task using the formula: [(single-task - dual-task)/single-task]* 100. A meta-analysis using a random-effects model pooled standardized mean differences (SMD) of DTC. Statistical significance was set at p < 0.05.
Results:
From 130 initially identified studies, eight were included in the review. Four studies with 374 participants were included in meta-analyses focusing on walking speed and step length. Three of the four studies indicated that tactile cueing improved DTC for these parameters. However, the SMD for walking speed (-109.69; 95 % CI -454.89 to 235.51, p = 0.39) and step length (-14.21; 95 %CI -53.25 to 24.83, p = 0.33) showed weak evidence of improvement.
Conclusion:
The meta-analysis provides weak evidence that tactile cueing may enhance walking speed and step length in DT conditions in PD. Rigorous objective studies are still lacking in this field of research.
