Cognitive reserve and executive functions in dual task gait performance in Parkinson's disease.

A higher level of education was correlated with less severe motor impairment in Parkinson's Disease (PD). Nevertheless, there is limited evidence on the relationship between cognitive reserve and motor performance in complex situations in PD. To investigate the association between cognitive reserve and the dual-task gait effect in PD. Additionally, we examined the relationship between executive function, clinical and sociodemographic variables and, dual-task gait effects. We conducted a cross-sectional study with 44 PD participants. We evaluated dual-task effect on cadence, stride length, and gait velocity. Dual-task effects were correlated with neurophysiological factors, including cognitive reserve (Cognitive Reserve Index Questionnaire), overall cognitive performance of executive functions, a specific executive function domain (Trail Making Test), and the global cognitive status (Montreal Cognitive Assessment and Mini-Mental State Examination). Age, gender, and disease severity were considered as variables to be examined for correlation. We found that cognitive reserve did not influence gait performance under dual-task conditions in this sample. However, executive functions, age, and disease severity were associated with the dual-task effect on gait. The overall cognitive performance with respect to the Trail Making Test showed an inverse relationship in the dual-task gait effect on cadence. Our study's findings have important implications for understanding the association between executive functions, age, and disease severity with the dual-task effect on gait in PD. Pre-life factors, such as education, occupation, and leisure activity, did not contribute to coping with complex gait situations in PD.

Directed connectivity in Parkinson's disease patients during over-ground and treadmill walking.

Treadmill walking is considered a useful therapeutic tool for improving gait in Parkinson's disease (PD) patients. The study investigated the role of top-down, frontal-parietal versus bottom-up parietal-frontal networks, during over-ground and treadmill walking in PD and control subjects, using functional connectivity. To this end, EEG was recorded simultaneously, during a ten-minute period of continuous walking either over-ground or on a treadmill, in thirteen PD patients and thirteen age-matched controls. We evaluated EEG directed connectivity, using phase transfer entropy in three frequency bands: theta, alpha and beta. PD patients showed increased top-down connectivity during over-ground compared with treadmill walking, in the beta frequency range. Control subjects showed no significant differences in connectivity between the two walking conditions. Our results suggest that in PD patients, OG walking was associated with increased allocation of attentional resources, compared with that on the TL. These functional connectivity modulations may shed further light on the mechanisms underlying treadmill versus overground walking in PD.

Chronic Functional Adaptations Induced by the Application of Transcranial Direct Current Stimulation Combined with Exercise Programs: A Systematic Review of Randomized Controlled Trials.

The present systematic review aimed to determine the chronic effects of the combination of transcranial direct current stimulation (tDCS) and exercise on motor function and performance outcomes. We performed a systematic literature review in the databases MEDLINE and Web of Science. Only randomized control trials that measured the chronic effect of combining exercise (comprising gross motor tasks) with tDCS during at least five sessions and measured any type of motor function or performance outcome were included. A total of 22 interventions met the inclusion criteria. Only outcomes related to motor function or performance were collected. Studies were divided into three groups: (a) healthy population (n = 4), (b) neurological disorder population (n = 14), and (c) musculoskeletal disorder population (n = 4). The studies exhibited considerable variability in terms of tDCS protocols, exercise programs, and outcome measures. Chronic use of tDCS in combination with strength training does not enhance motor function in healthy adults. In neurological disorders, the results suggest no additive effect if the exercise program includes the movements pretending to be improved (i.e., tested). However, although evidence is scarce, tDCS may enhance exercise-induced adaptations in musculoskeletal conditions characterized by pain as a limiting factor of motor function.

Test-Retest Reliability of the Timed Up and Go Test in Subjects with Parkinson's Disease: Implications for Longitudinal Assessments.

BACKGROUND: Despite the frequent use of the Timed Up and Go (TUG) test in clinical trials, evaluation of longitudinal test-retest reliability is generally lacking and still inconclusive for patients with Parkinson's disease (PD). OBJECTIVE: We aimed to further investigate long-term reliability and sensitivity of the TUG test among this population. Furthermore, we explored alternative assessment strategies of the test aimed at elucidating whether the inclusion or combination of timed trials may have potential implications on outcome measure. METHODS: Relative and absolute reliability of the TUG performance were obtained in forty-three subjects with PD over three timed trials in two different testing sessions separated by a two-months period. RESULTS: Our results reported excellent intra-session and moderate inter-session reliability coefficients. The use of different assessment strategies of the TUG was found to have an important impact on outcome measure, highlighting the averaging of several timed trials in each testing session as a recommended alternative to minimize measurement error and increase reliability in longitudinal assessments. Nevertheless, beyond acceptable reliability, poor trial-to-trial stability of the measure appears to exist, since the ranges of expected variability upon retesting were wide and the incidence of spurious statistical effects was not negligible, especially in longitudinal repeated testing. CONCLUSION: Limitations may exist in the interpretation of the TUG outputs as part of longitudinal assessments aimed at evaluating treatment effectiveness in PD population. Researchers and practitioners should be aware of these concerns to prevent possible misrepresentations of functional ability in patients for a particular intervention.

Role of Vertical Jumps and Anthropometric Variables in Maximal Kicking Ball Velocities in Elite Soccer Players.

Kicking is one of the most important skills in soccer and the ability to achieve ma ximal kicking velocity with both legs leads to an advantage for the soccer player. This study examined the relationship be tween kicking ball velocity with both legs using anthropometric measurements and vertical jumps (a squat jump (SJ); a countermovement jump without (CMJ) and with the arm swing (CMJA) and a reactive jump (RJ)). Anthropome tric measurements did not correlate with kicking ball velocity. Vertical jumps correlated significantly with kicking ball velocity using the dominant leg only (r = .47, r = .58, r = .44, r = .51, for SJ, CMJ, CMJA and RJ, respectively) . Maximal kicking velocity with the dominant leg was significantly higher than with the non-dominant leg (t = 18.0 4, p < 0.001). Our results suggest that vertical jumps may be an optimal test to assess neuromuscular skills involved in kicking at maximal speed. Lack of the relationship between vertical jumps and kicking velocity with the non-dominant leg may reflect a difficulty to exhibit the neuromuscular skills during dominant leg kicking.