Immediate Effects of Treadmill Gait Training Combined With Cognitive Tasks in Individuals With Parkinson's Disease: Randomized Controlled Trial

This is a trial involving subjects diagnosed with Parkinson's disease, in accordance with guidelines established by the London Brain Bank.

Individuals often must execute more than one task simultaneously during everyday life. When different activities that require attention are performed at the same time, a situation called Dual Task occurs.

Under normal conditions, motor cortex areas (primary motor cortex, pre-motor cortex and supplementary motor area) are responsible for selecting the range of movements in a given action sequence, in accordance with the demands of the task and environmental restrictions, and after the onset of movements brought about by the motor cortex, the basal nuclei continue execution, leaving the motor cortex free for other tasks that require attention. However, in Parkinson's disease, automaticity promoted by basal nuclei is compromised and constant conscious control becomes necessary during gait. Thus, when an activity concurrent with this function is performed, the frontal regions become dedicated to the secondary task and gait is predominantly controlled by defective basal nuclei, which generates negative Dual Task interference on gait.

Given the poor gait quality assessed in DT situations, individuals with PD have been instructed to avoid these circumstances. By contrast, recent evidence has demonstrated that gait training in conjunction with to secondary activities is capable of improving variables related to DT gait performance in PD.

Considering that treadmill gait training provides greater regularity and automaticity, allowing subjects to divert their attention to cognitive functions, this study hypothesizes that DT treadmill gait training combined with cognitive tasks will promote better gait performance in individuals with PD.