Introduction. It is well documented that freezing of gait (FoG) episodes occur in situations that are mentally challenging, such as dual tasks, consistent with less automatic control of gait in people with Parkinson disease (PD) and FoG. However, most physical rehabilitation does not include such challenges. The purpose was to determine (1) feasibility of a cognitively challenging Agility Boot Camp–Cognitive (ABC-C) program and (2) effects of this intervention on FoG, dual-task cost, balance, executive function, and functional connectivity. Methods. A total of 46 people with PD and FoG enrolled in this randomized crossover trial. Each participant had 6 weeks of ABC-C and Education interventions. Outcome measures were the following: FoG, perceived and objective measures; dual-task cost on gait; balance; executive function; and right supplementary motor area (SMA)–pedunculopontine nucleus (PPN) functional connectivity. Effect sizes were calculated. Results. ABC-C had high compliance (90%), with a 24% dropout rate. Improvements after exercise, revealed by moderate and large effect sizes, were observed for subject perception of FoG after exercise, dual-task cost on gait speed, balance, cognition (Scales for Outcomes in Parkinson’s disease–Cognition), and SMA-PPN connectivity. Conclusions. The ABC-C for people with PD and FoG is a feasible exercise program that has potential to improve FoG, balance, dual-task cost, executive function, and brain connectivity. The study provided effect sizes to help design future studies with more participants and longer duration to fully determine the potential to improve FoG.

中文翻译：

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认知挑战敏捷训练营计划，用于冻结帕金森病的步态

介绍。有充分证据表明，步态冻结 (FoG) 发作发生在精神上具有挑战性的情况下，例如双重任务，这与帕金森病 (PD) 和 FoG 患者步态的自动控制能力较差相一致。然而，大多数身体康复不包括这样的挑战。目的是确定 (1) 具有认知挑战性的敏捷训练营 - 认知 (ABC-C) 计划的可行性，以及 (2) 这种干预对 FoG、双任务成本、平衡、执行功能和功能连接的影响。方法。共有 46 名患有 PD 和 FoG 的人参加了这项随机交叉试验。每个参与者都有 6 周的 ABC-C 和教育干预。结果测量如下： FoG，感知和客观测量；步态的双任务成本；平衡; 执行功能; 和右侧辅助运动区（SMA）-桥脚核（PPN）功能连接。计算效果大小。结果。ABC-C 的依从性高 (90%)，辍学率为 24%。运动后的改善，通过中等和大的效应量显示，观察到受试者运动后对 FoG 的感知、步态速度、平衡、认知（帕金森病结果量表 - 认知）和 SMA-PPN 连接的双任务成本。结论。用于 PD 和 FoG 患者的 ABC-C 是一项可行的锻炼计划，有可能改善 FoG、平衡、双任务成本、执行功能和大脑连通性。该研究提供了效应量，以帮助设计未来的研究，参与者更多，持续时间更长，以充分确定改善 FoG 的潜力。