Objective: To verify the long-term efficiency of a new strategy based on declarative memory cues to improve the gait performance and independence in activities of daily living (ADL) in patients with Parkinson’s disease (PD).

Background: Deficits in automatic motor control, typical feature of PD, contribute to progressive impairment in gait performance. The use of declarative memory cues (DMC) in order to promote the engagement of attention and activation of the next movement in gait may minimize the consequences of lack of automatic control.We differentiate DMC from (1) external cue strategy since, after being memorized, the cues are internally generated from neural structures related to the declarative memory system. and (2) cognitive strategies because the key point for DMC consists of the usage of DMC for activating the next component of the sequence allowing a forward motor control, while cognitive strategies, involve general instructions to improve gait performance.

Methods: Design: Parallel prospective, single blind, randomized clinical trial. Participants: Forty-four patients with PD in stages 2-3 of disease evolution according to H&Y Classification. Interventions: The experimental training (ET) consisted of eight gait training sessions, twice a week, using the declarative memory cue strategy (DMCS). The control training (CT) consisted of a similar gait training without DMC. Primary outcome: Gait performance in terms of speed and stride length. Secondary outcome: Independence in ADL according to Section II of the Unified Parkinson’s disease Rating Scale. Randomization: Participants were randomized into a control group (CG) and an experimental group (EG), through blinded drawing of names. Statistical analysis: Gait performance and independence in ADL before, 2 and 60 days after the end of training were compared for CG and EG using RM-ANOVA.

Results: RM-ANOVA revealed a significant improvement of the gait performance in terms of speed and stride length and independence in ADL, remained until 2 months after the end of training, exclusively for the EG after DMC training.

Conclusions: Gait training associated to declarative memory cues promotes significant long-term improvements in gait performance and can be considered a new useful strategy to compensate the deficiency in automatic motor control of gait in PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/novel-training-based-on-declarative-memory-cues-improves-gait-perfromance-in-patients-with-parkinsons-disease-a-randomized-clinical-trial/