16-2 Effects of Computerized Cognitive Training

Effects of Computerized Cognitive Training on Gait and Mobility in Patients with Parkinson's Disease / Hagit Atias, Uzi Milman, Aner Weiss, Anat Mirelman, Jeffrey M. Hausdorff





Background and aims of the study:
A few computer-based studies have examined the effect of cognitive training on various populations and showed a positive emotional-cognitive effect in those populations. This type of intervention plan was also applied to Parkinson's Disease (PD) patients and results showed improvement in cognitive measures. Apparently, no previous study has attempted to explore the possibility of transferring intentional cognitive training to gait functions in PD patients.


The purpose of the study:  To investigate whether cognitive training designed to improve Executive Function (EF) ability could also improve gait function in PD patients.


Methods: This study is an interventional trial study.  The study involved patients with Parkinson's disease who were affiliated with the Haifa District of the Clalit HMO, and who were otherwise generally healthy and were computer literate. Patients' Age 50-80, Mini Mental State Examination (MMSE) score was > 25; their Hoehn and Yahr (H&Y) scores ranged between stages 1 and 3.  In the Lin Clinic's Physical Therapy Institute, every patient's cognition and gait abilities were measured one week before training, after training, and at 4 weeks post-training (follow up), in order to examine the long-term effects of training. Patients underwent 12 weeks of training on
their  home computer, using "AttenGo®"  cognitive program, consisting of 3 weekly sessions of 30 minutes each.


Results: 30 patients have participated in this study; 18 patients (60 %); mean age 67.32 (±  SD 6.41 years), have completed the research protocol. Findings indicated a significant change between the pre-training measures and those obtained in the follow up period, in the Global Cognitive Score (GCS) (P = .003), and in the Timed Up and Go (decreased from 11.73 seconds to 10.42 seconds (P=.030). In addition, a subgroup that demonstrated at least a 5 point (P =.031) improvement in EF also showed a significant improvement in step regularity in walking with dual tasking (DT).


Discussion: Used in combination with an adjunctive therapy such as physical therapy, computerized cognitive training can be an effective therapeutic tool for PD patients in the first stages of the disease. This combined treatment can provide guidance, help prevent further deterioration, and improve the walking and cognition capabilities of PD patients. However there are limitations to this study and therefore this line of research merits further study.

Key words:
Parkinson's Disease, Executive Function (EF), Timed Up and Go, computerized cognitive training , dual tasking (DT).

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