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The Effects of Practice on the Concurrent Performance of a Speech and Postural Task in Persons with Parkinson Disease and Healthy Controls

DOI: 10.1155/2013/987621

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Abstract:

Purpose. Persons with Parkinson disease (PD) demonstrate deficits in motor learning as well as bidirectional interference (the performance of one task concurrently interferes with the performance of another task) during dual-task performance. Few studies have examined the practice dosages necessary for behavioral change in rehabilitation relevant tasks. Therefore, to compare the effects of age and PD on motor learning during dual-task performance, this pilot study examined persons with PD as well as neurologically healthy participants during concurrent performance of postural and speaking tasks. Methods. Seven persons with PD and 7 healthy age-matched and 10 healthy young control subjects were tested in a motion capture facility. Task performances were performed concurrently and recorded during 3 time periods (acquisition (beginning and ending), 48-hour retention, and 1-week retention). Postural control and speech articulatory acoustic variables were measured. Results. Healthy young participants consistently performed better than other groups on all measured postural and speech variables. Healthy young participants showed decreased variability at retention, while persons with PD and healthy age-matched controls were unable to consistently improve their performance as a result of practice. No changes were noted in the speech variables. Conclusion. The lack of consistent changes in motor performance in any of the tasks, except in the healthy young group, suggests a decreased efficiency of motor learning in the age-matched and PD groups and argues for increased practice dosages during balance training. 1. Introduction Parkinson disease (PD) is thought to begin in the peripheral nervous system and progress to the central nervous system through the enteric, autonomic, and olfactory pathways [1]. Only with neuronal cell loss in the midbrain does PD begin to manifest its cardinal motor signs (akinesia, bradykinesia, tremor, rigidity, and postural instability). Although these motor signs are the most recognizable features of PD, the neurology community is developing a greater appreciation of deficits that extend beyond motor function [2]. Two signs of PD that may have profound implications for rehabilitation potential are the impairments of motor learning and difficulty with performance of concurrent motor tasks (dual-task deficits) [3, 4]. Previous research suggests that persons with PD can demonstrate retention of practiced tasks (defined as learning) [5]. However, the retention is generally not as good as the retention for persons without the disease, and

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