Investigation of Dual-Task Exercise's Effect in Parkinson's Disease

Effect of Dual-Task Interference on Upper Extremity Motor Experience With Parkinson's Disease

This study was conducted to investigate the effects of dual-task training on upper extremity motor functions in patients with Parkinson's disease. A total of 32 patients participated in the study. Patients were divided into two groups by randomization. One group received only conventional physiotherapy applications, while the other group performed dual-task exercises in addition. Dual-task exercises were performed while conventional treatment was applied. The treatment program was applied as 60x5x6 min/day/week.

Conventional treatment was determined according to the individual needs of the patients, including the lower and upper extremities. Dual-task interventions included performing such as counting backward, word recall, and reading words backward.

Assessments were repeated twice: Baseline and after a 30-session. "Demographic Information", "Movement Disorder Society (MDS)-Unified Parkinson's Disease Rating Scale (MDS-UPDRS)", "Box and Block Test" and "Parkinson Disease Questionnaire (PDQ-39) were used as assessment tools.

Study Overview

• Status: Completed
• Conditions: Parkinson Disease
• Intervention / Treatment: Other: Conventional Physiotherapy Program; Other: Dual-Task Interference

• Study Type: Interventional
• Enrollment (Actual): 32
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey
    • İstanbul Tıp Merkezi

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients aged 50-85 years with a diagnosis of Stage 1-3 Parkinson's disease, based on the Hoehn & Yahr Scale
• Patients had to have no issues with performing basic mathematical operations, - A Mini-Mental State Examination (MMSE) score above 24 points,
• Regular medication use for at least 4 weeks (for patients who were prescribed medical treatment),
• No comorbid neurological, neuromuscular, or orthopedic diseases

Exclusion Criteria:

• Patients with vision or hearing impairments,
• Moderate-to-severe fluctuations in tremor or dyskinesia,
• Having deep brain stimulator implants, or sensory loss in the upper extremities.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Conventional Therapy; This group were performed just conventional physiotherapy.	Other: Conventional Physiotherapy Program; The patients' conventional physiotherapy program included stretching, strengthening, balance, and coordination exercises according to their individual needs
Experimental: Dual-Task Interference; Dual-task exercises were applied during conventional physiotherapy practices.	Other: Conventional Physiotherapy Program; The patients' conventional physiotherapy program included stretching, strengthening, balance, and coordination exercises according to their individual needs; Other: Dual-Task Interference; This intervention consisted of counting backward, reading words backward, and remembering word exercises.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Movement Disorder Society (MDS)-Unified Parkinson's Disease Rating Scale (MDS-UPDRS):	The scale consists of four separate domains. The first section includes non-motor experiences in daily life (13 items), the second section includes motor experiences in daily life (13 items), the third section involves motor examination (33 items), and the last section addresses motor complications (6 items). The scale contains 65 individual items in total. Items are generally scored between 0-4, with some Yes/No items. The domains of the scale directly related to the upper extremities, including eating, dressing, cleaning, writing, rigidity, finger movements, hand movements, pronation and supination of the hand, postural tremor in the hands, kinetic tremor in the hands, resting tremor, and tremor persistence, were used in this study (Figure 1). The MDS-UPDRS scoring was performed while patients were in the "ON" state.	Baseline of the study
Movement Disorder Society (MDS)-Unified Parkinson's Disease Rating Scale (MDS-UPDRS):	The scale consists of four separate domains. The first section includes non-motor experiences in daily life (13 items), the second section includes motor experiences in daily life (13 items), the third section involves motor examination (33 items), and the last section addresses motor complications (6 items). The scale contains 65 individual items in total. Items are generally scored between 0-4, with some Yes/No items. The domains of the scale directly related to the upper extremities, including eating, dressing, cleaning, writing, rigidity, finger movements, hand movements, pronation and supination of the hand, postural tremor in the hands, kinetic tremor in the hands, resting tremor, and tremor persistence, were used in this study (Figure 1). The MDS-UPDRS scoring was performed while patients were in the "ON" state.	End of the 30th physiotherapy session

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Box Block Test (BBT)	The BBT consists of a panel and two boxes, one containing 150 wooden blocks. The patient is asked to transfer blocks from one box to another within 60 seconds, one block at a time, using only one hand. The test is repeated with both hands. The number of blocks moved provides the total score. A higher score indicates better manual dexterity.	Baseline of the study
Box Block Test (BBT)	The BBT consists of a panel and two boxes, one containing 150 wooden blocks. The patient is asked to transfer blocks from one box to another within 60 seconds, one block at a time, using only one hand. The test is repeated with both hands. The number of blocks moved provides the total score. A higher score indicates better manual dexterity.	End of the 30th physiotherapy session
Parkinson's Disease Questionnaire - 39 (PDQ-39)	This licensed tool assesses the quality of life associated with Parkinson's disease with a total of 39 items. Each item is scored between 0-4, with higher scores indicating poor quality of life. Responses are converted into hundredths for scoring, and the total score ranges from 0 to 100 points.	Baseline of the study
Parkinson's Disease Questionnaire - 39 (PDQ-39)	This licensed tool assesses the quality of life associated with Parkinson's disease with a total of 39 items. Each item is scored between 0-4, with higher scores indicating poor quality of life. Responses are converted into hundredths for scoring, and the total score ranges from 0 to 100 points.	End of the 30th physiotherapy session
Demographic Data Form	This form was developed by the investigators and included age, body mass index, disease duration, sex, dominant limb, education level, presence of freezing, presence of tremor, MMSE score, total daily dose of levodopa, and Hoehn & Yahr Staging.	Baseline of the study

Collaborators and Investigators

• Sponsor: Emre Şenocak

Study record dates

Study Major Dates

• Study Start (Actual): June 28, 2024
• Primary Completion (Actual): December 30, 2024
• Study Completion (Actual): December 30, 2024

Study Registration Dates

• First Submitted: January 27, 2025
• First Submitted That Met QC Criteria: January 30, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 30, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Synucleinopathies; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurodegenerative Diseases; Movement Disorders; Parkinsonian Disorders; Basal Ganglia Diseases; Parkinson Disease
• Other Study ID Numbers: 2024/109 (Other Identifier: Ethics Committee Protocol Number)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No