The Role Dual-Tasking Plays in People with Parkinson’s

Parkinson’s Disease (PD) is a devastating brain disorder caused by the impairment of nerve cells in the part of the brain that controls movement. The combination of two characteristic symptoms of PD can be very deleterious to a person’s overall health.

One symptom is a shuffling gait, and a struggle to continue to move forward (reported as a “freezing” sensation). The other symptom is decreased balance. Their balance is no longer controlled reflexively, like it is for the rest of us. Instead, they must pay more attention while they are walking in order to not lose their balance. The collective effect of both these symptoms is an increased fall risk for Parkinson’s patients.

To improve gait and balance, people with PD typically see a physical therapist to help them increase their stride length and reduce their chance of tripping. Counter to previous beliefs in which dual-tasking while walking could be detrimental to a person’s balance, research now shows dual-tasking can be an essential intervention in improving gait and balance in people with Parkinson’s, providing an alternative to the classic physical therapy techniques.

Sandra Brauer from the University of Queensland and Meg Morris from the University of Melbourne conducted a study on how added tasks and performing working memory tasks while walking can improve PD patients’ gait.

In their study, 20 participants with mild to moderate Parkinson’s had their baseline gait measured with and without added tasks, and then underwent a training period that included dual-task training to increase their gait. Subjects performed working memory tasks and counting tasks while they were walking and instructed to “take bigger steps”. As the training went on, the difficulty of the cognitive task increased.

After the training period, the subjects’ gait with the added tasks was measured again. The results of this study fully supported the hypothesis that dual-tasking training would improve gait in Parkinson’s patients. All 20 participants showed increased gait length after their dual-tasking training because they had learned how to focus more on the task, and less on the way they were walking (“reduced attention demand of gait”).

How does this relate to Nymbl Science? Nymbl uses a similar dual-tasking approach to train balance in older adults. Just like PD patients, balance in older adults is not as effectively controlled reflexively, but is instead something they have to consciously think about while performing their day-to-day tasks, ultimately creating a lot of anxiety.

As demonstrated in both the Parkinson’s study and in Nymbl users dual-tasking shifts balancefrom the frontal cortex (the “thinking” part of the brain) back to the cerebellum for reflexive balance control. For Nymbl users, performing simple exercises while interacting with fun cognitive tasks drives their balance control back to being reflexive.

The Brauer and Morris study is further proof that dual-tasking training has the power to transform balance in a wide range of people, which in turn leads to improved health and overall lifestyle.