E. Sarasso1,2,3, F. Agosta1,3, A. Gardoni1,2, A. Cristiano4, M.A. Volonté5, A. Tettamanti2, A. Sanna4, D. Trojaniello4, M. Filippi1,5,6,4
1IRCCS San Raffaele Scientific Institute, Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Milan, Italy, 2IRCCS San Raffaele Scientific Institute, Laboratory of Movement Analysis, Milan, Italy, 3Vita-Salute San Raffaele University, Milan, Italy, 4IRCCS San Raffaele Scientific Institute, Center for Advanced Technology in Health and Wellbeing, Milan, Italy, 5IRCCS San Raffaele Scientific Institute, Neurology Unit, Milan, Italy, 6IRCCS San Raffaele Scientific Institute, Neurophysiology Unit, Milan, Italy

Background: Parkinson’s disease (PD) patients with postural instability and gait disorders (PIGD) usually show reduced gait speed and postural stability performing attention-demanding tasks such as turning and dual-task. Difficulty performing dual-task is probably due to the automaticity loss and the consequent cognitive overload. Turning represents a challenge as it requests an increased cognitive load in order to modify the locomotor pattern and to increase interlimb coordination.

Purpose: To assess the effect of a single session of action observation (AO) on spatial-temporal dual-task gait parameters, particularly during the turning phase, in PD-PIGD patients.

Methods: Fourteen PD-PIGD patients were included and randomized into two groups: “AO group” and “Landscape group. Both groups performed a baseline evaluation including Timed Up and Go (TUG) test and TUG with cognitive dual-task (TUG-COG), which consisted in TUG while counting backwards by threes starting from 100 or 82. After the baseline acquisition, the AO group was asked to watch a video representing a high quality TUG performance while the Landscape group observed a control video. After the video observation, both groups performed again TUG and TUG-COG. Spatial-temporal gait parameters were acquired using a six cameras SMART-DX7000 optoelectronic system.

Results: After the video observation, the AO group showed a significant improvement in execution time both in TUG and TUG-COG and in turning stride length during TUG, while Landscape group did not show any significant change. AO group also showed a trend toward an increased mean turning velocity during TUG-COG.

Conclusion(s): In this study, a single session of AO showed the possibility to improve gait performance during TUG both with and without dual-task, particularly during turning that is one of the most challenging situations for PD-PIGD patients. We hypothesized that AO might facilitate motor-learning, thus reducing the necessity to control movement also during dual-task.

Implications: A randomized controlled trial investigating the effect of an AO training on dual-task gait abilities is needed to validate our hypothesis.

Funding, acknowledgements: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Keywords: Parkinson’s disease, action observation, dual task

Topic: Disability & rehabilitation

Did this work require ethics approval? Yes
Institution: IRCCS San Raffaele Scientific Institute; Milan, Italy
Committee: Human Research Ethics Committee of San Raffaele Scientific Institute, Milan, Italy
Ethics number: AOT-MI in PD-PIGD

All authors, affiliations and abstracts have been published as submitted.

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