Interference of functional dual-tasks on gait in untrained people with Parkinson's disease and healthy controls: a cross-sectional study.

BACKGROUND: In Parkinson's disease (PD) population, performing secondary tasks while walking further deteriorates gait and restrict mobility in functional contexts of daily life. This study (1) analyzed the interference of functional cognitive and motor secondary task on untrained people with PD and (2) compared their walking with healthy subjects. METHODS: Forty people with PD (aged 66.72 [7.5] years, Hoehn and Yahr stage I-II-III, on-medication) composed the PD group (PDG) and 43 participants (aged 66.60 [8.75] years) formed the group of healthy counterparts (HG). Gait was evaluated through spatiotemporal, kinematic and kinetic outcomes in five conditions: single task (ST) and visual, verbal, auditory and motor dual-task (DT). RESULTS: The velocity, stride length, and braking force performance of both groups was statistically higher in the ST condition than in verbal, auditory and motor DT (p < .05), and inferior in double support time and midstance force (p < .05). The same pattern was observed when compared the ST and visual DT condition, where participants showed a significantly higher stride length, double support time and braking force in the ST (p < .05). In addition, the PDG exhibited a significant shorter double support time and midstance force, and showed a higher braking force in the visual DT than in the verbal DT (p < .05). Similarly, the PDG showed a wider stride in the visual DT than in the motor DT condition (p < .05). PDG participants had a significantly lower performance than the HG in all the variables analyzed except for the maximum hip extension in the stance phase (p > .05). CONCLUSIONS: In untrained participants with PD, verbal and motor secondary tasks affect gait significantly, while auditory and visual tasks interfere to a lesser extent. Untrained people with PD have a poorer gait performance than their healthy counterparts, but in different grades according to the analyzed variables. TRIAL REGISTRATION: The data in this paper are part of a single-blind, randomized, controlled trial and correspond to the evaluations performed before a physical rehabilitation program, retrospectively registered with the number at clinicaltrial.govNCT04038866.

A blended-learning programme regarding professional ethics in physiotherapy students.

BACKGROUND: In the university context, assessing students' attitude, knowledge and opinions when applying an innovative methodological approach to teach professional ethics becomes fundamental to know if the used approach is enough motivating for students. RESEARCH OBJECTIVE: To assess the effect of a blended-learning model, based on professional ethics and related to clinical practices, on physiotherapy students' attitude, knowledge and opinions towards learning professional ethics. RESEARCH DESIGN AND PARTICIPANTS: A simple-blind clinical trial was performed (NLM identifier NCT03241693) (control group, n = 64; experimental group, n = 65). Both groups followed clinical practices for 8 months. Control group performed a public exposition of a clinical case about professional ethics. By contrast, an 8-month blended-learning programme regarding professional ethics was worked out for experimental group. An online syllabus and online activities were elaborated, while face-to-face active participation techniques were performed to discuss ethical issues. Students' attitudes, knowledge and opinions towards learning professional ethics were assessed. ETHICAL CONSIDERATIONS: The study was approved by the University Ethic Committee of Human Research and followed the ethical principles according to the Declaration of Helsinki. FINDINGS: After the programme, attitudes and knowledge towards learning professional ethics of experimental group students significantly improved, while no differences were observed in control group. Moreover, opinions reported an adequate extension of themes and temporization, importance of clinical practices and interest of topics. Case study method and role playing were considered as the most helpful techniques. CONCLUSION: The blended-learning programme proposed, based on professional ethics and related to clinical practices, improves physiotherapy students' attitudes, knowledge and opinions towards learning professional ethics.

Study of the Recovery Patterns of Elderly Subacute Stroke Patients in an Interdisciplinary Neurorehabilitation Unit.

BACKGROUND: This study seeks to establish the facts of the improvement over time in elderly poststroke patients. METHODS: A retrospective study was performed with regard to 106 subacute stroke patients aged older than 65 years, who were treated in an interdisciplinary neurorehabilitation unit. Three assessment points were established (on admission, 6 months post-onset, and 12 months post-onset), with the scores relative to 10 assessment scales having been collected at each point. RESULTS: By means of a principal component analysis, a first component was obtained, which is taken to represent a combined index of the 10 scales and to express the overall health status of the patient. An analysis of variance of this first component enabled a clear improvement trend to be identified, with this being more marked during the first 6-month period (72.7%) than the second 6-month period (27.3%). CONCLUSIONS: The elderly stroke patients underwent an interdisciplinary rehabilitation program lasting 1 year, experimented an initial period of rapid recovery during the first 6 months followed by a less marked period of improvement. However, no stabilization period in the patients' progress was found.