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There is evidence showing that cognitive-motor and motor training interventions, including balance, resistance and/or aerobic training, induce neuroplasticity in relevant brain regions as seen using functional magnetic resonance imaging (fMRI) or functional near-infrared spectroscopy (fNIRS) (Ruffieux, 2018; Eggenberger, 2016; Schattin, 2016, Godde, 2017). Exercise interventions involving balance training have the additional benefit of reducing the risk of falls in older people (Sherrington et al, 2017). A recent systematic review and meta-analysis also showed that volitional step training improves reaction time, gait and balance and reduces falls in older people (Okubo et al., 2017). In addition, a randomised-controlled trial of a computerised cognitive-motor step training intervention improved specific cognitive functions associated with falls in older people, i.e. processing speed, visuo-spatial ability as well as executive function and divided attention in participants with poorer baseline performance (Schattin et al, 2016). fNIRS is a remote imaging technology which can record cortical activity while people move. A randomised-controlled trial using fNIRS revealed that both a cognitive-motor exergame intervention and a balance training intervention significantly reduced bilaterally prefrontal cortex oxygenation at reassessment during treadmill walking, and that this hemodynamics change correlated with improved executive function (Eggenberger et al., 2016). The study of brain activity during stepping tasks using fNIRS might identify neural mechanisms underpinning hypothesised improvements in cognitive and motor functions subsequent to a cognitive-motor stepping training intervention. It might also characterise the brain activity responses specifically induced by the balance/ motor aspect of the training relative to the cognitive aspect. The aims of this study are to investigate the effects of cognitive-stepping training and cognitive-only training versus usual-care (control) on cortical activity during choice-stepping reaction time tasks in older people. We will compare relative changes in haemodynamic responses using fNIRS in cognitive and motor cortical regions of interest between each intervention group performing stepping tests, six months into the intervention (re-assessment) versus baseline. Cortical regions of interest include the prefrontal cortex, premotor cortex and supplementary motor cortex. We will also evaluate the association between change in stepping performance in tests of choice-stepping reaction time test (CSRT), inhibitory choice-stepping reaction time test (iCSRT), and Stroop stepping test (STT) and change in hemodynamic response during the stepping tests, at re-assessment relative to baseline.

Supplemental material, Table_S2_R1 for People With Parkinson’s Disease Exhibit Reduced Cognitive and Motor Cortical Activity When Undertaking Complex Stepping Tasks Requiring Inhibitory Control by Paulo H. S. Pelicioni, Stephen R. Lord, Yoshiro Okubo, Daina L. Sturnieks and Jasmine C. Menant in Neurorehabilitation and Neural Repair

Supplemental material, Figure_S1 for People With Parkinson’s Disease Exhibit Reduced Cognitive and Motor Cortical Activity When Undertaking Complex Stepping Tasks Requiring Inhibitory Control by Paulo H. S. Pelicioni, Stephen R. Lord, Yoshiro Okubo, Daina L. Sturnieks and Jasmine C. Menant in Neurorehabilitation and Neural Repair

A doença de Parkinson (DP) é caracterizada pelo início assimétrico de sintomas motores e compromete a destreza manual. Espera-se que pacientes com o lado de início da doença preferido comprometido consigam manter bom desempenho com o lado mais afetado (LMA) no teste de destreza manual decorrente da experiência motora ao longo da vida. O objetivo do estudo foi verificar a interferência da coincidência entre o lado de início da doença e preferência manual no desempenho da destreza manual, LMA e lado menos afetado, em pacientes com DP. Os pacientes foram distribuídos conforme o lado de início: Grupo Coincidente (lado preferido acometido) e Grupo Não Coincidente (lado não preferido acometido). A destreza manual foi avaliada pelo teste Annett Pegboard adaptado. A análise estatística ANOVA de dois fatores (grupo x lado), medidas repetidas no último fator, revelou que o Grupo Não Coincidente dispendeu maior tempo para completar o teste com o LMA (p=0,001), enquanto, o Grupo Coincidente dispendeu o mesmo tempo com ambos os lados, indicando que pacientes nos estágios iniciais e com início da doença pelo lado preferido perdem a proficiência manual. Sugere-se que intervenções para melhorar as habilidades manuais sejam aplicadas desde o diagnóstico da doença, principalmente em pacientes com o lado preferido acometido. Parkinson’s disease (PD) is characterized by the asymmetric onset of motor symptoms and manual dexterity. It is expected that patients with preferred onset side affected can maintain a good performance with the more affected side (MAS) due to the life-long motor experience. The aim of the study was to verify the interference of coincidence between the disease onset side and manual preference in the performance of manual dexterity, MAS and less affected side in patients with PD. The patients were distributed according to the disease onset side: Coincident group (preferred affected side) and non-coincident group (non-preferred affected side). Manual dexterity was assessed by the Annett Pegboard adapted test. The statistical analysis ANOVA for two factors (group x side), with repeated measures in the last factor, revealed that the Non-coincident group spent more time to complete the test with the MAS (p=0.001), while the Coincident group spent the same time to perform the test with both sides, indicating that patients in the early stages of PD and disease onset by preferred side lose the manual proficiency. Therefore, interventions to improve manual skills have become important since the diagnosis of the disease, especially in patients with the preferred affected side.

Made available in DSpace on 2018-11-12T17:28:15Z (GMT). No. of bitstreams: 0 Previous issue date: 2017. Added 1 bitstream(s) on 2018-11-12T17:36:20Z : No. of bitstreams: 1 S2448-24552017000100145.pdf: 253146 bytes, checksum: 80cc11107d28e45ac8e4f3f1f679b50a (MD5) RESUMO A instabilidade postural, um sinal/sintoma cardinal da doença de Parkinson (DP), é caracterizada pela associação entre alinhamento postural, amplitude de movimento e rigidez muscular. O objetivo foi analisar a relação entre o desempenho no teste de alcance funcional (TAF) e fatores relacionados a amplitude de movimento e aspectos clínicos da doença. Participaram 25 pessoas com DP nos estágios 1,0 e 1,5 da Hoehn e Yahr. As variáveis dependentes analisadas foram: desempenho no TAF e as pontuações nos itens da avaliação clínica da UnifiedParkinson’sDisease Rating Scale: teste de retropulsão, rigidez muscular e condição motora. A distância média no TAF foi de 25,3 cm e o deslocamento anteroposterior médio do centro de pressão foi de 2,69 cm. A amplitude de movimento articular do tornozelo está associada ao desempenho no TAF, enquanto a estabilidade postural está associada ao deslocamento anteroposterior do centro de pressão durante o TAF. Conclui-se que o desempenho no TAF em pessoas com DP é determinado pelo nível individual de equilíbrio e pela amplitude articular do tornozelo e a rigidez muscular e alterações funcionais do envelhecimento são responsáveis pelo desempenho no TAF. ABSTRACT Postural instability, a fundamental signal/symptom of Parkinson’s disease (PD), is characterized by the association between postural alignment, joint range of motion, and muscular rigidity. The aim of the present study was to analyze the relationship between performance in the functional reach test (FRT) and associated factors such as joint range of motion and PD clinical features. Twenty-five people with PD in stages 1 and 1.5 of the Hoehn & Yahr scale participated in the study. The analyzed dependent variables were: FRT performance and scores in the items of clinical evaluation of the Unified Parkinson’s Disease Rating Scale: pull-test, motor rigidity, and motor condition were used. The average distance in the FRT was 25.3 cm and the mean anterior-posterior displacement of the center of pressure was 2.69 cm. The ankle range of motion was associated with FRT performance, while postural stability was associated with the anterior-posterior displacement of the center of pressure during the FRT. We conclude that FRT performance in people with PD is determined by the individual level of balance and by the ankle joint amplitude and muscular rigidity and functional alterations due to aging are responsible for FRT performance. Universidade Estadual Paulista University of New South Wales Universidade Federal do Espírito Santo Universidade Estadual Paulista

A instabilidade postural, um sinal/sintoma cardinal da doença de Parkinson (DP), é caracterizada pela associação entre alinhamento postural, amplitude de movimento e rigidez muscular. O objetivo foi analisar a relação entre o desempenho no teste de alcance funcional (TAF) e fatores relacionados a amplitude de movimento e aspectos clínicos da doença. Participaram 25 pessoas com DP nos estágios 1,0 e 1,5 da Hoehn e Yahr. As variáveis dependentes analisadas foram: desempenho no TAF e as pontuações nos itens da avaliação clínica da Unified Parkinson’s Disease Rating Scale: teste de retropulsão, rigidez muscular e condição motora. A distância média no TAF foi de 25,3 cm e o deslocamento anteroposterior médio do centro de pressão foi de 2,69 cm. As amplitudes de movimento articular do tornozelo e joelho explicam 34% da variabilidade do desempenho no TAF, enquanto a estabilidade postural explica apenas 19% da variabilidade do deslocamento anteroposterior do centro de pressão durante o TAF. Conclui-se que o desempenho no TAF em pessoas com DP é determinado pelo nível individual de equilíbrio e pela amplitude articular do tornozelo e joelho e que rigidez muscular e alterações funcionais do envelhecimento são responsáveis pelo desempenho no TAF.