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Meta-Analysis
. 2023 Jun;270(6):2890-2907.
doi: 10.1007/s00415-023-11610-8. Epub 2023 Feb 23.

Effects of motor-cognitive training on dual-task performance in people with Parkinson's disease: a systematic review and meta-analysis

Hanna Johansson  1   2 , Ann-Kristin Folkerts  3 , Ida Hammarström  4 , Elke Kalbe  3 , Breiffni Leavy  4   5   6
Affiliations
Meta-Analysis

Effects of motor-cognitive training on dual-task performance in people with Parkinson's disease: a systematic review and meta-analysis

Hanna Johansson et al. J Neurol. 2023 Jun.

Abstract

Motor-cognitive training in Parkinson's disease (PD) can positively affect gait and balance, but whether motor-cognitive (dual-task) performance improves is unknown. This meta-analysis, therefore, aimed to establish the current evidence on the effects of motor-cognitive training on dual-task performance in PD. Systematic searches were conducted in five databases and 11 studies with a total of 597 people (mean age: 68.9 years; mean PD duration: 6.8 years) were included. We found a mean difference in dual-task gait speed (0.12 m/s (95% CI 0.08, 0.17)), dual-task cadence (2.91 steps/min (95% CI 0.08, 5.73)), dual-task stride length (10.12 cm (95% CI 4.86, 15.38)) and dual-task cost on gait speed (- 8.75% (95% CI - 14.57, - 2.92)) in favor of motor-cognitive training compared to controls. The GRADE analysis revealed that the findings were based on high certainty evidence. Thus, we can for the first time systematically show that people with PD can improve their dual-task ability through motor-cognitive training.

Keywords: Dual-task performance; Meta-analysis; Motor–cognitive training; Parkinson’s disease; Systematic review.

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Conflict of interest statement

Authors BL, HJ and IH: Declarations of interest: none. Author AKF has received grants from the German Parkinson Society and the German Alzheimer’s Society, as well as honoraria from Springer Medizin Verlag GmbH, Heidelberg, Germany; Springer-Verlag GmbH, Berlin; ProLog Wissen GmbH, Cologne, Germany; pro audito Switzerland, Zürich, Switzerland; Seminar- und Fortbildungszentrum Rheine, Germany; and LOGOMANIA, Fendt & Sax GbR, Munich, Germany. AFK is author of the cognitive intervention programs “NEUROvitalis” but receives no corresponding honoraria. Author EK has received grants from the German Ministry of Education and Research, ParkinsonFonds Deutschland gGmbH, the German Parkinson Society, and the German Alzheimer’s Society, and honoraria from Oticon GmbH, Hamburg, Germany; Lilly Pharma GmbH, Bad Homburg, Germany; Bernafon AG, Bern, Switzerland; and Desitin GmbH, Hamburg, Germany. EK is author of the cognitive intervention programs “NEUROvitalis” but receives no corresponding honoraria.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the screening process. Modified from Page et al. [44]
Fig. 2
Fig. 2
Forest plot. a Motor–cognitive training vs control. Outcome: dual-task gait speed. b Motor–cognitive training vs control. Outcome: dual-task cadence. c Motor–cognitive training vs control. Outcome: dual-task stride length. d Motor–cognitive training vs control. Outcome: dual-task stride length SD. e Motor–cognitive training vs control. Outcome: dual-task stride time SD. f Motor–cognitive training vs control. Outcome: dual-task double support. g Motor–cognitive training vs control. Outcome: dual-task cost on gait speed. h Motor–cognitive training vs control. Outcome: dual-task reaction time. i Motor–cognitive training vs control. Outcome: Timed Up and Go cognitive
Fig. 2
Fig. 2
Forest plot. a Motor–cognitive training vs control. Outcome: dual-task gait speed. b Motor–cognitive training vs control. Outcome: dual-task cadence. c Motor–cognitive training vs control. Outcome: dual-task stride length. d Motor–cognitive training vs control. Outcome: dual-task stride length SD. e Motor–cognitive training vs control. Outcome: dual-task stride time SD. f Motor–cognitive training vs control. Outcome: dual-task double support. g Motor–cognitive training vs control. Outcome: dual-task cost on gait speed. h Motor–cognitive training vs control. Outcome: dual-task reaction time. i Motor–cognitive training vs control. Outcome: Timed Up and Go cognitive
Fig. 3
Fig. 3
Risk of bias of included studies
See this image and copyright information in PMC

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