Browsing by Author "Puren, Michelle Sharon"

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    Executive function and an eight-week sensory-motor training programme in independent-living individuals with Parkinson’s disease.
    (Stellenbosch : Stellenbosch University, 2016-03) Puren, Michelle Sharon; Welman, Karen; Stellenbosch University. Faculty of Education. Dept. of Sport Science
    ENGLISH ABSTRACT : Introduction: Executive dysfunction is a common non-motor symptom of Parkinson’s Disease (PD). However, in individuals with PD, executive function (EF) is also associated with motor functions, i.e. gait and balance (Xu et al., 2015) and impaired EF is a predictor of future recurrent falls (Mak et al., 2014). Previous research in PD has shown selected improvements in EF through varied exercise interventions, such as aerobic exercise, resistance training and combination exercise (David et al., 2015; Duchesne et al., 2015; Tanaka et al., 2009). Nevertheless, no research to date has investigated the influence of a balance or sensory-motor training (SMT) programme on EF in isolation. Therefore the current study investigated whether an eight-week sensory-motor training programme would alter EF in non-demented individuals with mild to moderate PD. Methods: A convenience sample of 42 individuals with idiopathic PD was divided into an experimental (EXP) and a placebo (PBO) group. This was a time-series design with an eight-week baseline phase (pre- to mid-intervention), followed by an eight-week treatment phase (mid- to post-intervention) in both groups. The baseline phase was the control period in which the participants continued their normal activities with no intervention. The EXP (n = 25; Age: 66 ± 8years; Hoehn & Yahr (HY) stage: 2.5, 2.0 – 3.0; Movement Disorder Society – Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III rating: 31.9 ± 14.3) participated in an eight-week SMT, while the PBO (n = 17; Age: 71 ± 9years; HY: 2.0, 1.0 – 3.0; MDS-UPDRS III: 22.5 ± 10.0) wore a placebo feedback-wristband over the eight-week treatment phase. The primary outcome measures assessed were Updating (Trail Making Test, TMT), Set shifting (Wisconsin Card Sorting Test; WCST), Inhibition (Adapted Stroop Task), Perceived stability of balance (Activities-Specific Balance Confidence Scale; ABC) and Mobility (Timed Up and Go; TUG). Secondary outcome measures evaluated were Global cognition (Montreal Cognitive Assessment; MoCA), Disease severity (MDS-UPDRS and HY), Quality of life (Parkinson’s Disease Questionnaire; PDQ-39) and Depression (Hamilton Rating Scale for Depression; HAM-D). Participants were assessed at pre-, mid- and post-intervention over 16 weeks. Results: Treatment effects were observed for MDS-UPDRS III (p<0.01) and MDS-UPDRS total score (p=0.02), TMT A (p<0.0001), Global WCST Score (p<0.0001), Choice reaction time (CRT) 1: accuracy (p=0.04), CRT 2: time (p=0.007), Interference: accuracy (p<0.0001) and TUG (p<0.001). The EXP and PBO differed significantly at post-intervention in PDQ-39 variable Bodily discomfort (p=0.04), TMT A (p=0.03), CRT 2: time (p=0.01), Incongruent 1: time (p=0.04) and TUG (p<0.001).; and the changes over time in EXP, for the treatment phase for UPDRS II (p=0.04), PDQ-39 variable Stigma (p=0.01), CRT 2: time (p=0.048), ABC (p=0.01) and TUG (p<0.001). Conclusion: The eight-week SMT was beneficial for selected aspects of EF, namely Inhibition, perceived stability of balance, mobility and disease severity. The EF of Updating and Set shifting as well as global cognition, depressive moods, and quality of life, remained unchanged. Thus, a SMT programme has the potential to improve Inhibition and mobility in individuals with mild to moderate PD, which could result in better balance and a reduction in falls.