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Evaluation of the efficacy of physical therapy on cognitive decline at 6-month follow-up in Parkinson disease patients with mild cognitive impairment: a randomized controlled trial

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Abstract

Background

In Parkinson’s disease (PD), physical activity may represent a possible non-pharmacological intervention not only for improving motor symptoms but also for modulating cognitive impairment.

Aims

To evaluate the efficacy of an intensive physical program on cognitive functions in mid-stage PD patients with mild cognitive impairment (PD-MCI) over a 6-month follow-up.

Methods

This is a 6-month randomized controlled follow-up study. 40 PD-MCI patients were randomized to receive physical therapy (PT) or no specific intervention beside drug treatment (CT). Cognitive and motor assessments were performed at baseline (T0), 4 weeks after baseline (T1) and 6 months after T0. In a previous study, we reported a significant improvement in global cognitive functioning and attention/working-memory at T1. Here, we evaluated the residual effect of the training intervention at 6 months on both cognitive and motor performances.

Results

Intra-group analysis showed that at T2 most of cognitive and motor performances remained stable in the PT when compared to T0, while a significant worsening was observed in the CT. Between-group comparison at T2 showed significantly better results in PT than CT as regards MoCA and motor scales. The percentage change of cognitive and motor performances between T1 and T2 confirmed the benefit of physical therapy on global cognitive functioning scores (MMSE and MoCA).

Conclusions

In this follow-up extension of a longitudinal randomized controlled study, we demonstrated that physical therapy has a positive effect on cognitive functions, which extends beyond the duration of the treatment itself to, at least temporarily, reducing cognitive decline.

Trial registration

Trial registration number (ClinicalTrials.gov): NCT04012086 (9th July 2019).

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Data availability

The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found below: [Zenodo; 10.5281/zenodo.4710446].

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Funding

This work was supported by a grant of the Italian Ministry of Health (Ricerca Corrente 2017–2019).

Author information

Authors and Affiliations

  1. Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

    Micol Avenali & Cristina Tassorelli

  2. IRCCS Mondino Foundation, Via Mondino 2, 20100, Pavia, Italy

    Micol Avenali, Marta Picascia, Cristina Tassorelli, Elena Sinforiani & Sara Bernini

Authors
  1. Micol Avenali
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  2. Marta Picascia
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  3. Cristina Tassorelli
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  4. Elena Sinforiani
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  5. Sara Bernini
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Contributions

MA and SB: study concept and design, acquisition of data, analysis and interpretation of data, and drafting of the manuscript. All the authors: interpretation of data. MP: acquisition of data. ES and CT: critical revision of the manuscript for important intellectual content.

Corresponding author

Correspondence to Sara Bernini.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was performed in accordance with the guidelines of the Declaration of Helsinki. The study was approved by local Ethics Committee of San Matteo Hospital (Pavia, Italy).

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Informed consent was obtained from all individual participants included in the study.

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Avenali, M., Picascia, M., Tassorelli, C. et al. Evaluation of the efficacy of physical therapy on cognitive decline at 6-month follow-up in Parkinson disease patients with mild cognitive impairment: a randomized controlled trial. Aging Clin Exp Res 33, 3275–3284 (2021). https://doi.org/10.1007/s40520-021-01865-4

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