PTOTRCTDisability and rehabilitation2024

Associations between baseline cognitive status and motor outcomes after treadmill training in people with Parkinson's disease: a pilot study.

Raima M Amin, James J Phillips, Andrew T Humbert and 6 others

PMID 37010072

WHAT IT FOUND

People with Parkinson's and mild cognitive impairment improved their gait speed as much as those with normal cognition after treadmill training.

However, better memory scores at the start predicted larger speed gains. Motor severity also mattered: lower baseline symptoms linked to greater improvement.

Key findings

01There was no significant difference in gait improvements between participants with mild cognitive impairment and those with normal cognition.

02Better baseline memory performance was associated with greater long-term increases in gait speed.

03Lower motor severity scores at baseline were associated with greater increases in gait speed.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study was a pilot with a very small sample size (19 participants), which limits the certainty of the findings. The study was ended prematurely due to COVID-19 restrictions, impacting data collection for two participants. No confidence intervals were reported for most analyses due to small sample size and statistical assumptions. Multiple comparisons were made without adjustment, increasing the risk of false-positive findings. Training was exclusively on a treadmill, which may explain the lack of transfer to turning tasks. Dual-task walking trials were shorter than single-task trials to prevent fatigue, which could affect the reliability of some gait measures.

Declared interests

The authors report there are no competing interests to declare.

The easy way to misread this

Do not conclude that cognitive impairment has no impact on gait rehabilitation. While the group comparison showed no difference, the regression analysis found that better memory specifically predicted greater improvement. The lack of difference between groups may be due to the small sample size masking subtle effects.

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