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Improving dual task performance in early-onset Parkinson’s disease: Development of a
quantitative measure to detect change across the speech and limb motor systems.
BF. Farley, CM Fox, C Collins

While dual task performance is typically difficult for people with PD, no studies have investigated the effect of dual task training to determine if people with PD have the capacity to improve performance of one or both tasks. Improvement in dual tasks would suggest that either attentional (cortical) resources are expanded and/or that defective basal ganglia circuitry is capable of functional reorganization. We have developed an integrated speech and physical therapy program that intensively trains amplitude (bigness/loudness) simultaneously in the speech and limb motor system in people with Parkinson disease (PD). As a primary outcome measure, we tested the sensitivity of a novel dual task paradigm (tapping and speaking) to quantify change in both the limb and speech motor systems in the short term (one-week post intervention). Findings in one de novo subject suggest that dual training (Training Big and Loud) impacts improvements in both speech (loudness) and limb (fatigue, force variability, movement speed, pause time) and that the strategy may be dependent upon the cognitive-load imposed. Future studies will determine how dual task training impacts performance/learning across disease severity.

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