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Gamified Dual-Task Training for Individuals with Parkinson Disease: An Exploratory Study on Feasibility, Safety, and Efficacy

Author

Listed:
  • Lee-Kuen Chua

    (USC Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA)

  • Yu-Chen Chung

    (Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, TX 75390, USA)

  • David Bellard

    (Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90033, USA)

  • Laura Swan

    (Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90033, USA)

  • Nicole Gobreial

    (Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90033, USA)

  • Amanda Romano

    (USC Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA)

  • Ryan Glatt

    (Pacific Brain Health Center, Pacific Neuroscience Institute, Santa Monica, CA 90404, USA)

  • Michael A. Bonaguidi

    (USC Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
    Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
    Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
    Department of Gerontology, University of Southern California, Los Angeles, CA 90089, USA)

  • Darrin J. Lee

    (USC Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
    Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA)

  • Yi Jin

    (Brain Health Leadership Foundation, Reno, NV 89509, USA)

  • Charles Y. Liu

    (USC Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
    Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90033, USA
    Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
    Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA)

  • Beth E. Fisher

    (Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90033, USA
    Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
    Charles Y. Liu and Beth E. Fisher have equal senior authorship on this work.)

Abstract

Objectives: The feasibility and safety of the use of neurorehabilitation technology (SMARTfit ® Trainer system) by physical therapists in implementing a gamified physical-cognitive dual-task training (DTT) paradigm for individuals with Parkinson disease (IWPD) was examined. Additionally, the efficacy of this gamified DTT was compared to physical single-task training (STT), both of which were optimized using physio-motivational factors, on changes in motor and cognitive outcomes, and self-assessed disability in activities of daily living. Methods: Using a cross-over study design, eight participants with mild-to-moderate idiopathic PD (including one with mild cognitive impairment) completed both training conditions (i.e., gamified DTT and STT). For each training condition, the participants attended 2–3 sessions per week over 8.8 weeks on average, with the total amount of training being equivalent to 24 1 h sessions. A washout period averaging 11.5 weeks was inserted between training conditions. STT consisted of task-oriented training involving the practice of functional tasks, whereas for gamified DTT, the same task-oriented training was implemented simultaneously with varied cognitive games using an interactive training system (SMARTfit ® ). Both training conditions were optimized through continual adaptation to ensure the use of challenging tasks and to provide autonomy support. Training hours, heart rate, and adverse events were measured to assess the feasibility and safety of the gamified DTT protocol. Motor and cognitive function as well as perceived disability were assessed before and after each training condition. Results: Gamified DTT was feasible and safe for this cohort. Across participants, significant improvements were achieved in more outcome measures after gamified DTT than they were after STT. Individually, participants with specific demographic and clinical characteristics responded differently to the two training conditions. Conclusion: Physical therapists’ utilization of technology with versatile hardware configurations and customizable software application selections was feasible and safe for implementing a tailor-made intervention and for adapting it in real-time to meet the individualized, evolving training needs of IWPD. Specifically in comparison to optimized STT, there was a preliminary signal of efficacy for gamified DTT in improving motor and cognitive function as well as perceived disability in IWPD.

Suggested Citation

  • Lee-Kuen Chua & Yu-Chen Chung & David Bellard & Laura Swan & Nicole Gobreial & Amanda Romano & Ryan Glatt & Michael A. Bonaguidi & Darrin J. Lee & Yi Jin & Charles Y. Liu & Beth E. Fisher, 2021. "Gamified Dual-Task Training for Individuals with Parkinson Disease: An Exploratory Study on Feasibility, Safety, and Efficacy," IJERPH, MDPI, vol. 18(23), pages 1-21, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:23:p:12384-:d:687566
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