Improvement in Gait Performance after Training Based on Declarative Memory Cues in Patients with Parkinsons Disease: A Randomized Clinical Trial
|Maria Elisa Pimentel Piemonte1*, Erika Okamoto1, Carina Assis Ruggiero Cardoso2, Tatiana de Paula Oliveira, MS1, Camila Souza Miranda1, Marina Rigolin Pikel3, Felipe Augusto dos Santos Mendes4 and Gilberto Fernando Xavier5|
|1Department of Physiotherapy, Communication Science & Disorders, Occupational Therapy, School of Medicine, University of São Paulo, Brazil|
|2Brazil Parkinson Association, Brazil|
|3Department of Neuroscience and Behavior, Institute of Psychology, University of São Paulo, Brazil|
|4Department of Physiotherapy, University of Brasilia, Brazil|
|5Department of Physiology, Institute of Biosciences, University of São Paulo, Brazil|
|Corresponding Author :||Maria Elisa Pimentel Piemonte
Department of Physiotherapy, Communication Science & Disorders
Occupational Therapy, School of Medicine, University of São Paulo – USP
R. Cipotânea, 51, 05360- 160, São Paulo, Brazil
Tel: + 55 11 30917451
Fax: +55 11 30917461
E-mail: [email protected] usp.br
|Received October 31, 2015; Accepted November 25 2015; Published December 05, 2015|
|Citation: Piemonte MEP, Okamoto E, Cardoso CAR, Oliveira TP, MS, Miranda CS, et al. (2015) A Comparison between Task Oriented and Client-Centred Task-Oriented Approaches to Improve Upper Limb Functioning in People with Sub-Acute Stroke. J Nov Physiother 5:277. doi:10.4172/2165-7025.1000277|
|Copyright: © 2015 Piemonte MEP, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Background: Deficits in automatic motor control, a typical feature of Parkinson’s disease (PD), contribute to progressive impairment in gait performance. The use of declarative memory cues in order to promote the engagement of attention and activation of the next movement in gait may minimize the consequences of lack of automatic control.
Objectives: To verify the long-term efficiency of a new strategy based on declarative memory cues to improve the gait performance and independence in activities of daily living (ADL) in patients with PD.
Design: Parallel prospective, single blind, randomized clinical trial.
Setting: Brazil Parkinson Association.
Participants: Forty-four patients with PD in stages 2-3 of disease evolution according to Hoehn and Yahr Classification.
Interventions: The experimental training (ET) consisted of eight gait training sessions, twice a week, using the declarative memory cue strategy (DMCS). The control training (CT) consisted of a similar gait training without DMCS.
Primary outcome measure: Gait performance in terms of speed and stride length.
Secondary outcome measure: Independence in ADL according to Section II of the Unified Parkinson’s Disease Rating Scale.
Randomization: Participants were randomized into a control group (CG), which performed the CT, and an experimental group (EG), which performed the ET, through blinded drawing of names.
Statistical analysis: Gait performance and independence in ADL before, 2 and 60 days after the end of training were compared for CG and EG using RM-ANOVA.
Results: RM-ANOVA revealed a significant improvement of the gait performance in terms of speed and stride length and independence in ADL, remained until 2 months after the end of training, exclusively for the EG after ET.
Conclusion: Gait training associated to declarative memory cues promotes significant long-term improvements in gait performance and can be considered a new useful strategy to compensate the deficiency in automatic motor control of gait in PD patients.