The JFK BIG study: the impact of LSVT BIG® on dual task walking and mobility in persons with Parkinson's disease.
Sara Isaacson, Ashley O'Brien, Jennifer D Lazaro and 2 others
PMID 29706722WHAT IT FOUND
After LSVT BIG, 93 people with Parkinson’s disease had faster TUG times, including while reciting days backward.
The cup-carrying dual-task penalty did not show a clear improvement. No control group was used.
Key findings
01Mean TUG time decreased from 13.2 ± 6.9 seconds to 9.94 ± 3.53 seconds, mean TUG cognitive time decreased from 16.3 ± 10.5 seconds to 11.5 ± 6.1 seconds, and mean TUG motor time decreased from 16.0 ± 9.8 seconds to 11.7 ± 5.1 seconds, all p<0.001.
02Cognitive dual-task cost decreased significantly from 21.6% to 14.9%, while motor dual-task cost decreased from 21.8% to 17.8% but was not statistically significant.
03The number of subjects with greater than 10% dual-task cost decreased significantly for both motor and cognitive tasks, by 44.44% and 44.23% respectively.
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
There was no control group, so natural variation, testing effects, or other factors cannot be ruled out. The study was retrospective and used routine clinical records, not a planned trial with random allocation or blinding. No standardized Parkinson’s disease severity measure was collected, so the exact impairment level of the group is uncertain. Some participants reached a ceiling effect on the cognitive and motor secondary tasks, meaning the dual tasks may not have been hard enough to show the full difficulty. The TUG cognitive task used reciting days of the week backward, which differs from the original published TUG cognitive protocol. Only 93 of the 114 records reviewed met the data analysis criteria, so the analyzed group may not represent everyone who started LSVT BIG. The motor dual-task cost change was not statistically significant, so not every dual-task measure improved in a clear way. The records did not include motor and cognitive tasks performed without a second mobility task, so the study could not directly analyze how walking affected the secondary tasks.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that LSVT BIG caused the faster TUG times or reduced fall risk. This was a retrospective record review with no control group, and the motor dual-task cost change was not statistically significant.