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

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 and Beth E. Fisher
Additional contact information
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
Darrin J. Lee: USC Neurorestoration Center, 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
Beth E. Fisher: Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90033, USA

IJERPH, 2021, vol. 18, issue 23, 1-21

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.

Keywords: Parkinson’s disease; integrated dual-task training; motor-cognitive training; gamified rehabilitation; neurotechnology; physical therapy modalities; optimized intervention; exergaming; neurological rehabilitation; patient-focused intervention (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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