Effects of Tactile Cueing on Functional Movement Modulation in Parkinson's Disease
Ivkovic, Vladimir 1977-
MetadataShow full item record
Parkinson Disease (PD) is the second most prevalent neurodegenerative disorder in the United States. The symptoms include decreased movement automaticity, greater reliance on external sensory cues and attention-dependent (executive) motor control. Visual and auditory cueing have been shown to transiently improve motor-cognitive performance in PD patients. However audiovisual processing shares many cognitive resources used for attention-dependent situational awareness. Conversely, tactile cues are processed faster, with minimal attentional demand, and may be more efficient means for modulating motor-cognitive performance. To date, no studies systematically investigated the efficacy and limitations of tactile cueing (TC) in modulating motor-cognitive performance in PD and healthy individuals. The objectives of this study were to investigate the efficacy and characterize the functional limitations of TC in: (1) modulating simple (heel tapping) and complex (straight line walking) motor tasks over a range of cueing intervals; (2) improving gait performance; (3) improving motor-cognitive performance on complex functional gait tasks (walking and turning while carrying tray with cups of water). The study was performed on 10 PD patients (71 ± 9 years) and 10 healthy individuals (69 ± 7 years). TC was delivered through a smart phone controlled by a custom-developed application. The results indicate that (1) PD patients and healthy individuals were able to use TC to effectively modulate performance on simple (seated heel tapping) and complex (straight line walking) motor tasks; (2) increase in task complexity and decrease in TC intervals reduce synchronized motor performance accuracy – PD patients are able to modulate performance at a narrower range of cueing intervals than healthy individuals; (3) TC improves PD patients’ turn cadence and turn times in dual tasks; (4) PD patients use TC opportunistically when their motor-cognitive resources are highly challenged (turning while carrying a tray with cups of water); (5) TC is a useful method for improving motor-cognitive integration for PD patients performing challenging tasks. This study provides novel insight about the role of TC in PD movement modulation and the mechanisms of motor-cognitive integration in PD patient population. The custom-developed TC smart phone application was validated and represents a new addition in the repertoire of available walking aids.