Multiple-task walking training in people with mild to moderate Parkinson's disease: a pilot study

Objective: To determine whether multiple-task training of walking is feasible and worthwhile in people with mild to moderate Parkinson's disease. Design: Baseline-controlled pilot study with three-week baseline, training and retention phases. Setting: University research laboratory. Subjects: Five people aged 61 ±8 years with mild to moderate Parkinson's disease (Hoehn and Yahr stages II—III). Interventions: Multiple-task training was performed for 30 minutes once a week during the three-week training phase. Main measures: Participants were tested and trained during the `on' phase of medication. Feasibility of training was examined using 10 cm visual analogue scales to measure participant perception of mental fatigue, physical fatigue, difficulty, anxiety and confidence. Walking velocity, stride length and cadence under multiple-task conditions were measured. Results: Participants reported low levels of mental fatigue, physical fatigue, difficulty and anxiety as well as high levels of confidence associated with multiple-task training. No adverse effects of training were reported. Multiple-task walking velocity increased by 0.09 ± 0.06 m/s (95% confidence interval (CI) 0.02 to 0.16) between the baseline and training phase and this increase was maintained in the retention phase. Conclusion: Multiple-task training is feasible in people with mild to moderate Parkinson's disease. The data suggest sustained benefits on multiple-task walking velocity are possible. A randomized controlled trial of multiple-task training efficacy is warranted.