| Institution: | 1. University of Houston, Center for Neuromotor and Biomechanics Research at The National Center for Human Performance, 2450 Holcombe Boulevard, Houston, TX 77021, USA;2. Movement Disorders and Neurorehabilitation Center, Methodist Neurological Institute, 6560 Fannin Street, Suite 802, Houston, TX 77030, USA;1. Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH;2. Cleveland Clinic Concussion Center, Cleveland Clinic, Cleveland, OH;3. Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH;1. Department of Physical Therapy Education, Elon University, Elon, NC, USA;2. Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA;1. Department of Neurology & Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China;2. Laboratory of Neurodegenerative Diseases & Key Laboratory of Stem Cell Biology, Institute of Health Science, Shanghai Institutes for Biological Sciences(SIBS), Chinese Academy of Sciences (CAS) & Shanghai Jiao Tong University School of Medicine, Shanghai, China;3. St George Hospital, Kogarah, NSW, Australia;4. Department of Nutritional Sciences, Pennsylvania State University, USA;1. Department of Health and Human Performance, University of Houston, Houston, TX, USA;2. Center for Neuromotor and Biomechanics Research, Houston, TX, USA |
| Abstract: | IntroductionVisual and auditory cueing improve functional performance in Parkinson's disease (PD) patients. However, audiovisual processing shares many cognitive resources used for attention-dependent tasks such as communication, spatial orientation, and balance. Conversely, tactile cues (TC) may be processed faster, with minimal attentional demand, and may be more efficient means for modulating motor-cognitive performance. In this study we aimed to investigate the efficacy and limitations of TC for modulating simple (heel tapping) and more complex (walking) motor tasks (1) over a range of cueing intervals, (2) with/without a secondary motor task (holding tray with cups of water).MethodsTen PD patients (71 ± 9 years) and 10 healthy controls (69 ± 7 years) participated in the study. TCs was delivered through a smart phone attached to subjects' dominant arm and were controlled by a custom-developed Android application.ResultsPD patients and healthy controls were able to use TC to modulate heel tapping (F(3.8,1866.1) = 1008.1, p < 0.001), and partially modulate walking (F(3.5,1448.7) = 187.5, p < 0.001) tasks. In the walking task, PD patients modulated performance over a narrower range of cueing intervals (R2 = 0.56) than healthy controls (R2 = 0.84; group difference F(3.5,1448.7) = 8.6, p < 0.001). TC diminished synchronization error associated with performance of secondary motor task during walking in PD patients and healthy controls (main effect of Task (F(1,494) = 0.4; p = 0.527), Task X Group interaction (F(1,494) = 0.5; p = 0.493)).ConclusionThis study expands modalities of TC usage for movement modulation and motor-cognitive integration in PD patients. The smartphone TC application was validated as a user-friendly movement modulation aid. |
