title: Can cognitive remediation improve mobility in patients with Parkinson's disease? Findings from a 12 week pilot study.
abstract: BACKGROUND
  Patients with Parkinson's disease (PD) suffer from impaired gait and mobility. These changes in motor function have been associated with cognitive deficits that also commonly co-occur in PD, especially executive function (EF) and attention.
  
  
  OBJECTIVE
  We hypothesized that a cognitive remediation program would enhance gait and mobility.
  
  
  METHODS
  The 18 PD patients in this study were assessed at baseline and again one and four weeks after completion of a 12 week long, home-based computerized cognitive training program. Subjects were asked to "play" computer games designed to improve EF and attention for 30 minutes a day, three times per week for 12 weeks, while seated. The Timed Up and Go (TUG), gait speed, and stride time variability quantified mobility. A previously validated, computerized neuropsychological battery quantified global cognitive function and its sub-domains.
  
  
  RESULTS
  Compared to pre-training values, global cognitive scores and time to complete the TUG significantly improved after the training. TUG components of turning speed and duration also improved. Other TUG components, gait speed, and variability did not change after training.
  
  
  CONCLUSIONS
  These initial findings suggest that computerized cognitive training can improve cognitive function and has a beneficial carryover effect to certain aspects of mobility in patients with PD. Additional studies are required to replicate these findings and more fully assess the underlying mechanisms. Nonetheless, the present results underscore the motor-cognitive link in PD and suggest that computerized cognitive training may be applied as a therapeutic option to enhance mobility in patients with PD.
authors: Clinical Research Unit, Clalit Health Services, Haifa and Western Galilee District, Israel Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors: Uzi
authors: U
authors: Milman
authors: Lin Medical Center and Clalit Medical Services, Haifa, Israel.
authors: Hagit
authors: H
authors: Atias
authors: Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors: Aner
authors: A
authors: Weiss
authors: Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors: Anat
authors: A
authors: Mirelman
authors: Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel Department of Physical Therapy, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel Department of Medicine, Harvard Medical School, Boston, MA, USA.
authors: Jeffrey M
authors: JM
authors: Hausdorff
mesh_terms: D000368:Aged; D001288:Attention; D015928:Cognitive Behavioral Therapy; D056344:Executive Function; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000523:psychology / Q000628:therapy*; D010865:Pilot Projects; D013813:Therapy, Computer-Assisted
keywords: Cognitive training; Parkinson's disease; attention; body-fixed sensor; cognitive function; executive function; gait; instrumented Timed Up and Go; mobility