Factors Associated With Responsiveness to Gait and Balance Training in People With Parkinson Disease

Abstract

Background and purpose: Although increasing evidence supports the benefit- of exercise among people with Parkinson disease (PwPD), it is unclear whether a given exercise modality suits all PwPD, given the heterogeneity of the disease. The purpose of this study was to explore factors associated with responsiveness to a highly challenging training intervention that incorporated dual-task exercises.

Methods: Forty-seven PwPD (mean age: 73 years; 19 females, Hoehn and Yahr stages 2-3) who had participated in 10 weeks of highly challenging gait and balance training were included. Baseline demographics, disease-related factors, physical and cognitive ability, and perceived health were used for the prediction of percent change in balance performance (the Mini-BESTest) and comfortable gait speed between the pre- and postassessments, using multiple linear regression analyses.

Results: Thirty-five percent of the variance of change in balance performance was explained by General Health Perceptions (β = -0.36), the Timed Up and Go test (β = -0.33), and the single-task performance of a cognitive task (β = -0.24). Forty-nine percent of change in gait speed was explained by gait speed while performing a dual task (β = -0.46), dual-task interference while walking (β = 0.43), time to complete the Timed Up and Go test (β = -0.29), and percent error on a cognitive task (β = -0.25).

Discussion and conclusions: The results may suggest that the PwPD with overall lower perceived health, functional mobility, and cognitive functions are the ones most likely to benefit from highly challenging and attention-demanding gait and balance training.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A240).

Trial registration: ClinicalTrials.gov NCT01417598.