Piemonte MEP, Oliveira TP, Miranda CS, Guelfi ETN, Souza CO, Okamoto E and Xavier GF
Objective: This study evaluated the effects of extensive motor training in a finger-to-thumb opposition sequence task on performance and automaticity of patients at early and intermediate stages of Parkinson’s disease (PD).
Methods: Fifteen PD patients in stage 1 of Hoehn and Yahr classification, 15 patients in stages 2 and 3, and 20 healthy matched control individuals, were extensively exposed to a 5-element finger-to-thumb opposition sequence task, 2 sessions per week, along 5 weeks. On session 1 the participants performed a specified sequence of movements along 60 seconds in a single-task condition; the number of sequences completed correctly was recorded. On sessions 2 to 9 the subjects were exposed to 600 repetitions per session of the same sequence of movements. On session 10 the participants performed 4 different 60-second-duration trials including (1) the trained sequence and (2) a novel sequence, both in a single-task condition, and (3) the trained sequence and (4) a novel sequence, both concurrently with a verbal fluency task, therefore in a dual-task condition. The number of sequences completed correctly was recorded.
Results: All groups exhibited improvement of performance for the trained sequence. However, as expected, this improvement was relatively greater for the control subjects as compared to that seen for PD patients. Performance in the dual-task condition disrupted performance of all groups. However, while for control subjects this disruption was smaller for the trained as compared to the novel sequence, thus indicating automaticity for the trained sequence, for PD patients disruption was equivalent for trained and novel sequences.
Conclusion: Extensive motor training promotes improvement of performance in PD patients at different stages of the disease. However, this improvement is not associated with development of automaticity for the trained sequence. It seems important to take this information into account when planning therapeutic training approaches for PD patients.