The Adapted Resistance Training with Instability Randomized Controlled Trial for Gait Automaticity

Author(s):Show less -

Vieira-Yano, Bianca ^{[1, 2]} ; Martini, Douglas N. ^[3] ; Horak, Fay B. ^[3] ; de Lima-Pardini, Andrea ^[4] ; Almeida, Filipe ^[1] ; Santana, Vagner P. ^[1] ; Lima, Daniel ^[1] ; Batista, Alana X. ^[5] ; Marquesini, Raquel ^[6] ; Lira, Jumes ^{[6, 1]} ; Barbosa, Egberto R. ^[7] ; Corcos, Daniel M. ^[8] ; Ugrinowitsch, Carlos ^[6] ; Silva-Batista, Carla ^{[6, 1, 2]}

Affiliation

^[1] Univ Sao Paulo, Exercise Neurosci Res Grp, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Sch Arts Sci & Humanities, St Arlindo Bettio 1000, BR-03828000 Vila Guaraciaba, SP - Brazil

^[3] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 - USA

^[4] Queens Univ, Ctr Neurosci Studies, Kingston, ON - Canada

^[5] Univ Sao Paulo, Dept Radiol, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Sch Phys Educ & Sport, Lab Neuromuscular Adaptat Strength Training, Sao Paulo - Brazil

^[7] Univ Sao Paulo, Sch Med, Dept Neurol, Movement Disorders Clin, Sao Paulo - Brazil

^[8] Northwestern Univ, Dept Phys Therapy & Human Movement Sci, Chicago, IL 60611 - USA

• Document type: Journal article
• Source: MOVEMENT DISORDERS; v. 36, n. 1, p. 152-163, JAN 2021.
• Web of Science Citations: 0

Abstract

Background Deficits in the cerebellar locomotor region (CLR) have been associated with loss of gait automaticity in individuals with freezing of gait in Parkinson's disease (freezers); however, exercise interventions that restore gait automaticity in freezers are lacking. We evaluated the effects of the adapted resistance training with instability ({[}ARTI] complex exercises) compared with traditional motor rehabilitation (without complex exercises) on gait automaticity and attentional set-shifting. We also verified associations between gait automaticity change and CLR activation change previously published. Methods Freezers were randomized either to the experimental group (ARTI, n = 17) or to the active control group (traditional motor rehabilitation, n = 15). Both training groups performed exercises 3 times a week for 12 weeks. Gait automaticity (dual-task and dual-task cost {[}DTC] on gait speed and stride length), single-task gait speed and stride length, attentional set-shifting (time between Trail Making Test parts B and A), and CLR activation during a functional magnetic resonance imaging protocol of simulated step initiation task were evaluated before and after interventions. Results Both training groups improved gait parameters in single task (P < 0.05), but ARTI was more effective than traditional motor rehabilitation in improving DTC on gait speed, DTC on stride length, dual-task stride length, and CLR activation (P < 0.05). Changes in CLR activation were associated with changes in DTC on stride length (r= 0.68,P= 0.002) following ARTI. Only ARTI improved attentional set-shifting at posttraining (P < 0.05). Conclusions ARTI restores gait automaticity and improves attentional set-shifting in freezers attributed to the usage of exercises with high motor complexity. (c) 2020 International Parkinson and Movement Disorder Society (AU)

• FAPESP's process: 18/16909-1 - Effects of resistance training with instability on clinical outcomes, spinal mechanisms, and brain metrics in individuals with freezing of gait in Parkinson's disease
• Grantee: Carla da Silva Batista
• Support Opportunities: Scholarships abroad - Research Internship - Post-doctor
• FAPESP's process: 16/13115-9 - Effects of resistance training with instability on clinical outcomes, spinal mechanisms, and brain metrics in individuals with freezing of gait in Parkinson's disease
• Grantee: Carla da Silva Batista
• Support Opportunities: Scholarships in Brazil - Post-Doctoral