In the past, it has been recommended that people with Parkinson’s should avoid doing another task while walking (dual tasking), so that the quality of walking (step length and speed) does not worsen. However, a study conducted by Brauer and Morris (2010) looked at the potential of people with PD to be trained to walk with long steps under dual tasking conditions. Twenty participants with mild-moderate PD were asked to perform added tasks (e.g. carrying a tray with four wine glasses, transfer-ring coins between pockets, saying as many words as possible beginning with a certain letter) while walking along a 10 metre path. They practised the dual tasking for 20 minutes, and the focus was on improving step length as they followed the verbal command of ‘big steps’. The study showed that, while dual tasking interferes with walking, the participants walked with larger steps when performing most of the added tasks after training. In addition, improvements in dual tasking were also possible in a group of people who were older, had longer disease duration, whose walking was more affected than others. Specificity of walking training was also evident – improvements were only noted in step length which was the focus of the training; speed and number of steps did not improve significantly.
Although this is a generalisation, this study suggests that practise enables people with PD to improve walking pattern while performing added tasks – the aspect of walking (step size, speed, number of steps) that improves depends on the specific target of the training.
In real life situations, it is more often that we are dual or multitasking, even when we think we are only doing one task – for example, you could be walking on a straight level path along the promenade, but you are also actually thinking about the direction you need to go, the obstacles around you (other people, bikes, buggies, dogs), do you keep your coat on or take it off, oh, and have you locked the door on the way out? Remember that dual/multi-tasking is not solely movement but also mental activity. Therefore, the importance of complexity in exercise training is useful all around, but more specifically to people with PD as it provides additional neuro-protection to the brain pathways that PD affects.
To view an illustration of this concept, download the PD Warrior App (Apple/Android), where you will find video demonstrations of the 10 Core Exercises.https://pdwawarrior.com/app-info/ You will not-ice that all the exercises have dual or multiple compon- ents to include dif-ferent body parts as well as coordina-tion, choreography, and planning.
Curious? Come and join us in our first 10-Week Challenge Group Class. Please note this class is open to clients who have completed the induct-ion, and spaces are limited. Come and join the global PD Warrior tribe, take control of your Parkinson’s, and live the life you deserve. I look forward to seeing you soon!
Ability Neuro Physio is your local PD Warrior licenced facility for Swansea
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Reference: Brauer, S.G. and Morris, M.E. Can people with Parkinson’s disease improve dual tasking when walking? Gait and Posture. 2010; 31:229-233.