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Motor–Cognitive Treadmill Training With Virtual Reality in Parkinson’s Disease: The Effect of Training Duration

Lookup NU author(s): Professor Lynn RochesterORCiD, Dr Lisa AlcockORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Copyright © 2022 Pelosin, Ponte, Putzolu, Lagravinese, Hausdorff, Nieuwboer, Ginis, Rochester, Alcock, Bloem, Nieuwhof, Cereatti, Della Croce, Mirelman and Avanzino. Treadmill training with virtual reality (TT + VR) has been shown to improve gait performance and to reduce fall risk in Parkinson’s disease (PD). However, there is no consensus on the optimal training duration. This study is a sub-study of the V-TIME randomized clinical trial (NCT01732653). In this study, we explored the effect of the duration of training based on the motor–cognitive interaction on motor and cognitive performance and on fall risk in subjects with PD. Patients in Hoehn and Yahr stages II–III, aged between 40 and 70 years, were included. In total, 96 patients with PD were assigned to 6 or 12 weeks of TT + VR intervention, and 77 patients completed the full protocol. Outcome measures for gait and cognitive performance were assessed at baseline, immediately after training, and at 1- and 6-month follow-up. The incident rate of falls in the 6-month pre-intervention was compared with that in the 6-month post-intervention. Dual-task gait performance (gait speed, gait speed variability and stride length under cognitive dual task and obstacle negotiation, and the leading foot clearance in obstacle negotiation) improved similarly in both groups with gains sustained at 6-month follow-up. A higher decrease in fall rate and fear of falling were observed in participants assigned to the 12-week intervention than the 6-week intervention. Improvements in cognitive functions (i.e., executive functions, visuospatial ability, and attention) were seen only in participants enrolled in 12-week training up to 1-month follow-up but vanished at the 6-month evaluation. Our results suggest that a longer TT + VR training leads to greater improvements in cognitive functions especially those directly addressed by the virtual environment.

Publication metadata

Author(s): Pelosin E, Ponte C, Putzolu M, Lagravinese G, Hausdorff JM, Nieuwboer A, Ginis P, Rochester L, Alcock L, Bloem BR, Nieuwhof F, Cereatti A, Della Croce U, Mirelman A, Avanzino L

Publication type: Article

Publication status: Published

Journal: Frontiers in Aging Neuroscience

Year: 2022

Volume: 13

Print publication date: 05/01/2022

Online publication date: 05/01/2022

Acceptance date: 17/11/2021

Date deposited: 09/02/2022

ISSN (electronic): 1663-4365

Publisher: Frontiers Media S.A.


DOI: 10.3389/fnagi.2021.753381


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Funder referenceFunder name
FP7 project V-TIME-278169