EFFECT OF MOTOR AND COGNITIVE DUAL TASK ON HAND FUNCTION IN PATIENTS WITH PARKINSON’S DISEASE

Abstract

Purpose: Activities of daily living mostly require dual-task (DT) performance. Functional status in daily living activities in Parkinson’s disease (PD) may be affected from the interaction between motor and cognitive function. This study aimed to investigate the effect of motor and cognitive DT on hand function in patients with PD . Methods: Thirty-three patients with PD aged between 50 and 80 years and age and sex-matched 32 healthy individuals were included in the study. A nine-hole peg test (NHPT) was used to evaluate hand function. Motor DT and cognitive DT were assessed using the rhythmic tapping of foot and seven subtraction tests during NHPT. The results of NHPT were recorded in seconds under single task, motor DT, and cognitive DT. The percentage of DT interference was calculated. Measurements were repeated for the dominant and non-dominant hand. Results: In the PD group, dominant and non-dominant hand function during both motor and cognitive DT decreased more than the control group (p<0.05). In both groups, cognitive DT decreased hand function more prominently than motor DT (p<0.05). When the DT interference percentages were compared, there was no significant difference between the groups in terms of motor DT interference (p>0.05), whereas the interference in the PD group was higher in cognitive DT interference than the control group (p<0.05). Conclusion: Hand function of patients with PD decreases under DT conditions. The decrease is apparent, particularly during the cognitive DT. Among the rehabilitation objectives of patients with PD should also include the enhancement of DT performance during hand function. Addition of DT oriented exercises, primarily cognitive task, to the rehabilitation program of patients with PD, may be useful to improve hand function in patients with PD.

PARKİNSON HASTALARINDA MOTOR VE BİLİŞSEL İKİLİ GÖREVLERİN EL FONKSİYONU ÜZERİNE ETKİSİ

Öz

Amaç: Günlük yaşam aktiviteleri büyük çoğunlukla ikili görev (İG) performansı gerektirir. Parkinson hastalığında (PH) bireyin günlük yaşamdaki fonksiyonel durumu, motor ve bilişsel fonksiyon arasındaki etkileşimden etkilenebilir. Bu çalışmanın amacı, Parkinson hastalarında motor ve bilişsel İG’nin el fonksiyonuna etkisini incelemekti. Yöntem: Çalışmaya 50-80 yaş arası 33 PH ve benzer yaş ve cinsiyet dağılımına sahip 32 sağlıklı birey dahil edildi. El fonksiyonunu değerlendirmek için dokuz delikli peg testi (DDPT) kullanıldı. Motor İG, DDPT sırasında ayağın ritmik vurması ile, bilişsel İG ise, DDPT sırasında seri yedi çıkarma testi ile değerlendirildi. DDPT sonuçları tek görev, motor İG ve bilişsel İG altında saniye cinsinden kaydedildi. İG etkileşim yüzdesi hesaplandı. Ölçümler dominant ve dominant olmayan el için tekrarlandı. Sonuçlar: PH grubunda dominant ve dominant olmayan el fonksiyonunun hem motor hem de bilişsel İG sırasında kontrol grubuna göre daha fazla azaldığı görüldü (p<0,05). Her iki grupta da bilişsel İG’nin, el fonksiyonunu motor İG’den daha fazla azalttığı belirlendi (p<0,05). İG etkileşim yüzdeleri karşılaştırıldığında, motor İG etkileşimi açısından gruplar arasında anlamlı bir fark olmadığı (p>0,05); bilişsel İG etkileşim açısından ise PH grubunda etkileşimin kontrol grubuna göre daha fazla olduğu görüldü (p<0,05). Tartışma: PH olan bireylerin el fonksiyonu İG altında azalmaktadır. Bu azalma özellikle bilişsel İG sırasında daha fazladır. PH olan hastaların rehabilitasyon hedefleri arasında el fonksiyonu sırasında İG performansının artırılması da yer almalıdır. PH olan hastaların rehabilitasyon programına özellikle bilişsel görev içerikli İG’e yönelik egzersizlerin eklenmesi, el fonksiyonunu geliştirmede yararlı olabilir.

Anahtar Kelimeler

• El fonksiyonu
• İkili görev
• Parkinson hastalığı

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