Objective: To test the applicability of a new rehabilitation program for people with Parkinson´s disease combining web-based cognitive training with motor exercises.

Background: Parkinson´s disease (PD) typically results in significant functional disabilities affecting posture, gait, daily living activities and cognition. There is growing evidence for the positive benefits of non-pharmacological interventions, such as physiotherapy and cognitive training or even their combination in multitask training programs. Combining such interventions may be a new potential intervention that comes in line with the impending positive evidence on multitask training. However, uncertainties persist about the most beneficial type of exercises, intensity, patient´s preferences and long term adherence in real-word clinical practice.

Methods: The COGWEB CNS Move program consisted of PD-specific cognitive and motor exercise sessions lead by a physiotherapist specialized in PD and cognitive training. Physical exercises (e.g., sitting, standing, walking, turning, reaching) were combined with computerized cognitive exercises from the COGWEB program, displayed on a screen in the gym. Applicability was assessed during the sessions through patient satisfaction questionnaires and an inventory of potential adverse events.

Results: Five participants with a diagnose of PD, mean age of 68 years, Hoehn & Yahr I-III, and medically stable were included. Ten weekly individual sessions were performed over three months (1h/week). During the sessions several adjustments occured to the type of physical activities, length, verbal feedback, learning time, cognitive and physical activities applied to the COGWEB exercises. Risk of falling had to be continuously monitored by the physiotherapist, with verbal and non-verbal cues to correct risk behaviors in standing and gait activities. This risk was more perceived when the participant was challenged to divide attention between tasks. All participants completed the study with no adverse events. Results from the questionnaires showed participants were satisfied with the type of the exercises, enjoyed themselves and were willing to repeat the program.

Conclusions: Our results suggest that the selected combination of cognitive and motor interventions was suitable to people with PD. Safety precautions are recommended when undertaking dual task training.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/applicability-study-of-a-multitask-cognitive-and-motor-exercise-program-for-individuals-with-parkinsons-disease-the-cogweb-cns-move-program/