#BrainLifeGoals Project Grant Winner 2020

Motor-cognitive dual task training for Parkinson’s disease (PD) has been shown to potentially benefit people with PD. It is rapidly growing in popularity with a strong social media presence and evidence of its global implementation. But how effective are these benefits, what are the risks and how successful are the implementations of this novelty intervention? Is this implementation mainly based on professional expertise or current evidence?
Healthcare professionals struggle to access the evidence for this type of motor-cognitive training for PD, as well as to access practical expert knowledge and guidance of when, how, and to who to apply it for the different phases of PD progression. Notably, there is an optimal minimal level of disease-specific expertise necessary to integrate dual task practice, particularly with respect to safely integrating exercises and reducing the risk of falls and other possible safety issues. By prematurely applying this type of exercise approach to people with PD, health professionals with a lack of professional expertise, may favor unnecessary procedures, foster unrealistic expectations in patients (particularly those with less favorable profiles), and could ultimately be putting patients at risk of falls and/or injury. Yet, its benefits have been shown in preliminary evidence.

As such, it is critical to enhance expertise among professionals who deliver such dual task exercise programs, provide adequate ongoing educational support, and share continuous feedback from people with PD undertaking it. All these actions can begin to guide us away from care disparities and promote better care for people with Parkinson. Without them, no amount of evidence will ever matter.

Ultimately, we believe that several courses of action may be needed to address the gap between expertise, evidence, dissemination, and its implementation into exercise practices. The project here proposed will represent one of those steps.

Our project will consist of an educational video for health care professionals to gain practical knowledge on the evidence, benefits, risks, and safety implications of cognitive-motor exercise programs for people living with Parkinson PD. It will be developed and featured on a dedicated awareness webpage on the EPDA website.

The video will include patients’ testimonies from people living with PD dealing with difficulties in daily life activities under dual task circumstances. Additionally, people with PD will be involved in designing questions for the patient interviews. The video will also include theoretical presentations from experts and examples of exercises they may use to address dual task difficulties referred by the patients. Researchers and clinicians will be included to help support an evidenced-based content selection.

Our project will be rolled out at national and international levels through translations of the video to 5 main languages in Europe to facilitate world-wide dissemination. This will allow it to be transferable to other countries and regions by dissemination via all EPDA member associations. Collective efforts of countries, society organizations, communities, individuals, private sector in promoting a strategy geared towards facilitating better implementation of new practices in PD is the shorter route to increasing better care for people with PD.

Helping people with Parkinson access safe and effective treatments in Europe is one of the central goals of the EPDA. As such, our project is an awareness raising initiative on the proliferation of cognitive-motor exercises with limited evidence and expertise and an educational building initiative to help health professionals to be better equipped to apply cognitive-motor exercises. In addition to providing information and training to healthcare professionals on this new exercise topic, we expect that increasing public interest in cognitive-motor dual task exercise programs may also potentially positively influence the direction of clinical research and advance clinical practice.