Professionals' Self-Reported Difficulties towards Integrating Dual Task Training in Care for People with Parkinson's Disease.

John Dean,Catarina Godinho,Josefa Domingos,Júlio Belo Fernandes

doi:10.3390/ijerph19031281

Abstract

Background: Despite the growing use of dual task training (DTT) in clinical practice with people with Parkinson Disease (PD), there is still limited evidence on how to best implement it. Data regarding professionals’ difficulties when integrating such practices are critical as a first step to generate further guidance on how to apply it. The aim of this study was to identify the difficulties perceived by professionals to integrate dual task in their practice. Methods: A descriptive, observational and cross-sectional study was conducted using a web-based survey. Convenience sampling was used to recruit exercise and healthcare professionals working with people with PD through various social media channels. Data were collected and then analyzed thematically using the method of constant comparisons. The study report follows the consolidated criteria for reporting qualitative research (COREQ) checklist. Results: Of the 205 eligible responses, 68.8% were Physiotherapist. The majority of the participants reported having Parkinson-specific training (91.7%) and 59.0% applied DTT in individual one-on-one sessions. We identified ten categories of difficulties faced by professionals. Conclusions: Professionals struggle to integrate DTT into PD clinical care. Challenges were identified and the most significant refer to difficulties in managing the chronicity of the disease and lack of patient compliance with home exercises. Understanding current challenges towards dual task exercise will help to reflect upon strategies to be applied effectively and safe.

Highlights

Parkinson’s disease (PD) is one of the fastest-growing neurological diseases [1] affecting an estimated 10 million people [2,3]
We offer an international landscape of dual task training for people with Parkinson Disease (PD), that may guide potential reflections on solutions for the difficulties identified to integrate DTT in care
The use of DDT in people with PD is an emerging area of clinical interest but implementation is still a struggle [20,21,23]. This qualitative study has identified several difficulties reported by health and exercise professionals in applying DTT which are likely to influence the way care is applied by professionals in clinical practice

Summary

Introduction

Parkinson’s disease (PD) is one of the fastest-growing neurological diseases [1] affecting an estimated 10 million people [2,3]. PD is a complex disease affecting posture, gait, and speech with far reaching impact on daily living activities [4–6]. In addition to these motor disturbances, people with PD may experience a wide range of non-motor symptoms, such as gastrointestinal disturbances, autonomic dysfunctions, sleep problems, sensory manifestations, neuropsychiatric and cognitive symptoms negatively contributing to severe disability and reduced life expectancy [7]. Despite the growing use of dual task training (DTT) in clinical practice with people with Parkinson Disease (PD), there is still limited evidence on how to best implement it. The aim of this study was to identify the difficulties perceived by professionals to integrate dual task in their practice.

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Results

Discussion

Conclusion