A multimodal training modulates short-afferent inhibition and improves complex walking in a cohort of faller older adults with an increased prevalence of Parkinson's disease

Elisa Pelosin, Cecilia Cerulli, Carla Ogliastro, Giovanna Lagravinese, Laura Mori, Gaia Bonassi, Anat Mirelman, Jeffrey M Hausdorff, Giovanni Abbruzzese, Roberta Marchese, Laura Avanzino

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Falls are frequent in Parkinson's disease and ageing. Impairments in the cholinergic-mediated attentional supervision of gait may contribute to increased fall risk, especially when obstacles challenge gait. Interventions combining motor-cognitive approaches have been shown to improve motor performance, cognitive skills and falls number. Here, we hypothesized that an intervention simulating an attention-demanding walking condition could impact not only complex gait performance and fall risk but also short-latency afferent inhibition (SAI), as a marker of cholinergic activity.

METHODS: Thirty-nine participants at falls risk (24 Parkinson's disease subjects and 15 older adults) were recruited in a randomized controlled trial. Participants were assigned to treadmill training or treadmill training with non-immersive virtual reality intervention and trained 3 times a week for 6 weeks. SAI, a transcranial magnetic stimulation paradigm, was used to assess cholinergic activity. Gait kinematics was measured during usual walking and while negotiating physical obstacles. Transcranial magnetic stimulation and gait assessments were performed pre, post, and 6 months post intervention.

RESULTS: Treadmill training combined with non-immersive virtual reality induced an increase in inhibition of the SAI protocol on cortical excitability, improved obstacle negotiation performance and induced a reduction of the number of falls compared to treadmill training. Furthermore, the more SAI increased after training, the more the obstacle negotiation performance improved and fall rate decreased.

Original languageEnglish
JournalThe journals of gerontology. Series A, Biological sciences and medical sciences
DOIs
Publication statusE-pub ahead of print - Mar 15 2019

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Gait
Walking
Parkinson Disease
Negotiating
Cholinergic Agents
Transcranial Magnetic Stimulation
Biomechanical Phenomena
Randomized Controlled Trials
Inhibition (Psychology)

Cite this

@article{7ec5d83afb5e4da589467fcf9b50fd66,
title = "A multimodal training modulates short-afferent inhibition and improves complex walking in a cohort of faller older adults with an increased prevalence of Parkinson's disease",
abstract = "BACKGROUND: Falls are frequent in Parkinson's disease and ageing. Impairments in the cholinergic-mediated attentional supervision of gait may contribute to increased fall risk, especially when obstacles challenge gait. Interventions combining motor-cognitive approaches have been shown to improve motor performance, cognitive skills and falls number. Here, we hypothesized that an intervention simulating an attention-demanding walking condition could impact not only complex gait performance and fall risk but also short-latency afferent inhibition (SAI), as a marker of cholinergic activity.METHODS: Thirty-nine participants at falls risk (24 Parkinson's disease subjects and 15 older adults) were recruited in a randomized controlled trial. Participants were assigned to treadmill training or treadmill training with non-immersive virtual reality intervention and trained 3 times a week for 6 weeks. SAI, a transcranial magnetic stimulation paradigm, was used to assess cholinergic activity. Gait kinematics was measured during usual walking and while negotiating physical obstacles. Transcranial magnetic stimulation and gait assessments were performed pre, post, and 6 months post intervention.RESULTS: Treadmill training combined with non-immersive virtual reality induced an increase in inhibition of the SAI protocol on cortical excitability, improved obstacle negotiation performance and induced a reduction of the number of falls compared to treadmill training. Furthermore, the more SAI increased after training, the more the obstacle negotiation performance improved and fall rate decreased.",
author = "Elisa Pelosin and Cecilia Cerulli and Carla Ogliastro and Giovanna Lagravinese and Laura Mori and Gaia Bonassi and Anat Mirelman and Hausdorff, {Jeffrey M} and Giovanni Abbruzzese and Roberta Marchese and Laura Avanzino",
note = "{\circledC} The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.",
year = "2019",
month = "3",
day = "15",
doi = "10.1093/gerona/glz072",
language = "English",
journal = "Journals of Gerontology - Series A Biological Sciences and Medical Sciences",
issn = "1079-5006",
publisher = "Oxford University Press",

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TY - JOUR

T1 - A multimodal training modulates short-afferent inhibition and improves complex walking in a cohort of faller older adults with an increased prevalence of Parkinson's disease

AU - Pelosin, Elisa

AU - Cerulli, Cecilia

AU - Ogliastro, Carla

AU - Lagravinese, Giovanna

AU - Mori, Laura

AU - Bonassi, Gaia

AU - Mirelman, Anat

AU - Hausdorff, Jeffrey M

AU - Abbruzzese, Giovanni

AU - Marchese, Roberta

AU - Avanzino, Laura

N1 - © The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2019/3/15

Y1 - 2019/3/15

N2 - BACKGROUND: Falls are frequent in Parkinson's disease and ageing. Impairments in the cholinergic-mediated attentional supervision of gait may contribute to increased fall risk, especially when obstacles challenge gait. Interventions combining motor-cognitive approaches have been shown to improve motor performance, cognitive skills and falls number. Here, we hypothesized that an intervention simulating an attention-demanding walking condition could impact not only complex gait performance and fall risk but also short-latency afferent inhibition (SAI), as a marker of cholinergic activity.METHODS: Thirty-nine participants at falls risk (24 Parkinson's disease subjects and 15 older adults) were recruited in a randomized controlled trial. Participants were assigned to treadmill training or treadmill training with non-immersive virtual reality intervention and trained 3 times a week for 6 weeks. SAI, a transcranial magnetic stimulation paradigm, was used to assess cholinergic activity. Gait kinematics was measured during usual walking and while negotiating physical obstacles. Transcranial magnetic stimulation and gait assessments were performed pre, post, and 6 months post intervention.RESULTS: Treadmill training combined with non-immersive virtual reality induced an increase in inhibition of the SAI protocol on cortical excitability, improved obstacle negotiation performance and induced a reduction of the number of falls compared to treadmill training. Furthermore, the more SAI increased after training, the more the obstacle negotiation performance improved and fall rate decreased.

AB - BACKGROUND: Falls are frequent in Parkinson's disease and ageing. Impairments in the cholinergic-mediated attentional supervision of gait may contribute to increased fall risk, especially when obstacles challenge gait. Interventions combining motor-cognitive approaches have been shown to improve motor performance, cognitive skills and falls number. Here, we hypothesized that an intervention simulating an attention-demanding walking condition could impact not only complex gait performance and fall risk but also short-latency afferent inhibition (SAI), as a marker of cholinergic activity.METHODS: Thirty-nine participants at falls risk (24 Parkinson's disease subjects and 15 older adults) were recruited in a randomized controlled trial. Participants were assigned to treadmill training or treadmill training with non-immersive virtual reality intervention and trained 3 times a week for 6 weeks. SAI, a transcranial magnetic stimulation paradigm, was used to assess cholinergic activity. Gait kinematics was measured during usual walking and while negotiating physical obstacles. Transcranial magnetic stimulation and gait assessments were performed pre, post, and 6 months post intervention.RESULTS: Treadmill training combined with non-immersive virtual reality induced an increase in inhibition of the SAI protocol on cortical excitability, improved obstacle negotiation performance and induced a reduction of the number of falls compared to treadmill training. Furthermore, the more SAI increased after training, the more the obstacle negotiation performance improved and fall rate decreased.

U2 - 10.1093/gerona/glz072

DO - 10.1093/gerona/glz072

M3 - Article

JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

SN - 1079-5006

ER -