Document Type : Research Paper

Authors

1 Department of Motor Behavior, Tehran University, Tehran, Iran

2 Associate Professor, Department of Motor Behavior, Tehran University, Tehran, Iran

3 Assistant Professor, Department of Motor Behavior, Tehran University, Tehran, Iran

4 Arak University, Academic member

Abstract

. The purpose of this study was to examine whether a cognitive training intervention leads to significant improvements on measures of balance and gait in schizophrenia inpatient with depression disorder. This non-randomized clinical trial with a control group examined the effect of cognitive training over 12 weeks on balance and gait in 20 man schizophrenia inpatients with depression disorder. Patients were homogeneously(based on age, score of MMSE, scor of depression) assigned to groups of intervention and control . Participations enrolled in intervention group attended in cognitive rehabilitation of memory and attention(ARAM( sessions for 45–60 minutes three times weekly for 12 weeks (36 total sessions). Data of Pre-test and post-test resulting from the test of standing on dominant leg with opened and closed eyes ,10-meter gait speed, 10-meter gait speed under gait-visuospatial dual-task condition and 10-meter gait speed under gait-motor dual-task condition were analyzed by using pair- samples t- test and comparing the post-test of the two groups analyzed by using independent t-test. Results showed the cognitive training intervention group had significant increase in static balance with opened and closed eyes and gait speed under single and dual-task condition from pre-test to post-test (p≤0.05). the cognitive training intervention group had significant improve in static balance with opened and closed eyes, gait speed under single and dual-task condition rather than the control group.

Keywords

Main Subjects

  1. Walther S. Psychomotor symptoms of schizophrenia map on the cerebral motor circuit. Psychiatry Research: J Neuroimaging. 2015;233(3):293-8
  2. Sanders RD, Keshavan MS, Schooler NR. Neurological examination abnormalities in neuroleptic-naive patients with first-break schizophrenia: preliminary results. Am J Psychiatry. 1994;151(8):1231-3.
  3. Walther S, Strik W. Motor symptoms and schizophrenia. Neuropsychobiology. 2012;66(2):77-92.
  4. Kirkpatrick B, Messias E, Harvey PD, Fernandez-Egea E, Bowie CR. Is schizophrenia a syndrome of accelerated aging? Schizophr Bull. 2007;34(6):240-32.
  5. Tsai M-T, Lee S-M, Chen H-K, Wu B-J. Association between frailty and its individual components with the risk of falls in patients with schizophrenia spectrum disorders. Schizophr. Res. 2018;197:138-43.
  6. Stubbs B, Gaughran F, Mitchell AJ, De Hert M, Farmer R, Soundy A, et al. Schizophrenia and the risk of fractures: a systematic review and comparative meta-analysis. Gen Hosp Psychiatry. 2015;37(2):126-33.
  7. Noohu MM, Dey AB, Hussain ME. Relevance of balance measurement tools and balance training for fall prevention in older adults. Journal of Clinical Gerontology and Geriatrics. 2014;5(2):31-5.
  8. Marvel CL, Schwartz BL, Rosse RB. A quantitative measure of postural sway deficits in schizophrenia. Schizophr. Res. 2004;6(3)363-7.
  9. Zhao Q, Li Z, Huang J, Yan C, Dazzan P, Pantelis C, et al. Neurological soft signs are not “soft” in brain structure and functional networks: evidence from ALE meta-analysis. Schizophr Bull. 2014;40(3):626-41.
  10. Putzhammer A, Heindl B, Broll K, Pfeiff L, Perfahl M, Hajak G. Spatial and temporal parameters of gait disturbances in schizophrenic patients. Schizophr. Res. 2004;69(2-3):159-66.
  11. Hasan A, Nitsche MA, Herrmann M, Schneider-Axmann T, Marshall L, Gruber O, et al. Impaired long-term depression in schizophrenia: a cathodal tDCS pilot study. Brain Stimul. 2012;5(4):475-83.
  12. Prizer LP, Smith ML, Housman J, Ory MG. Depressive symptomology management and falls among middle aged and older adults. Aging Ment Health. 2016;20(1):13-21.
  13. Drevets WC, Furey ML. Replication of scopolamine's antidepressant efficacy in major depressive disorder: a randomized, placebo-controlled clinical trial. Biol Psychiatry. 2010;67(5):43-8.
  14. Visser JE, Bloem BR. Role of the basal ganglia in balance control. Neural Plast. 2005;12(2-3):161-74.
  15. Lemke MR, Wendorff T, Mieth B, Buhl K, Linnemann M. Spatiotemporal gait patterns during over ground locomotion in major depression compared with healthy controls. J Psychiatr Res. 2000;34(4-5):277-83.
  16. Montero-Odasso M, Schapira M, Soriano ER, Varela M, Kaplan R, Camera LA, et al. Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. The Journals of Gerontology Series A: J. Gerontol. A Biol. Sci. Med. Sci. 2005;60(10):1304-9.
  17. Yogev‐Seligmann G, Hausdorff JM, Giladi N. The role of executive function and attention in gait. Movement disorders: Mov. Disord. 2008;23(3):329-42.
  18. Baddeley AD, Baddeley H, Bucks R, Wilcock G. Attentional control in Alzheimer's disease. Brain. 2001;124(8):1492-508.
  19. Andreasen NC. The role of the thalamus in schizophrenia. Can J Psychiatry.1997;42(1):27-33.
  20. Ouhaz Z, Fleming H, Mitchell AS. Cognitive functions and neurodevelopmental disorders involving the prefrontal cortex and mediodorsal thalamus. Front Neurosci. 2018;12:33.
  21. Giraldo-Chica M, Rogers BP, Damon SM, Landman BA, Woodward ND. Prefrontal-thalamic anatomical connectivity and executive cognitive function in schizophrenia. Biol Psychiatry. 2018;83(6):509-17.
  22. Dux PE, Tombu MN, Harrison S, Rogers BP, Tong F, Marois R. Training improves multitasking performance by increasing the speed of information processing in human prefrontal cortex. Neuron. 2009;63(1):127-38
  23. Lallart E, Jouvent R, Herrmann FR, Perez-Diaz F, Lallart X, Beauchet O, et al. Gait control and executive dysfunction in early schizophrenia.J Neural Transm. 2014;121(4):443-50.
  24. Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture. 2002;16(1):1-14.
  25. Killane I, Donoghue OA, Savva GM, Cronin H, Kenny RA, Reilly RB. Relative association of processing speed, short-term memory and sustained attention with task on gait speed: a study of community-dwelling people 50 years and older. J. Gerontol. A Biol. Sci. Med. Sci. 2014;69(11):1407-14.
  26. Chan RC, Chen EY, Law C. Specific executive dysfunction in patients with first-episode medication-naive schizophrenia. Res. 2006,82(1):64-51.
  27. Konradsen L. Sensori-motor control of the uninjured and injured human ankle. J Electromyogr Kinesiol. 2002;12(3):199-203.
  28. Simons DJ, Boot WR, Charness N, Gathercole SE, Chabris CF, Hambrick DZ, et al. Do “brain-training” programs work? Psychol Sci Public Interest. 2016;17(3):103-86.
  29. Montero‐Odasso M, Verghese J, Beauchet O, Hausdorff JM. Gait and cognition: a complementary approach to understanding brain function and the risk of falling. J Am Geriatr Soc. 2012;60(11):2127-36.

 

 

  1. Boisgontier MP, Beets IA, Duysens J, Nieuwboer A, Krampe RT, Swinnen SP. Age-related differences in attentional cost associated with postural dual tasks: increased recruitment of generic cognitive resources in older adults. Neurosci Biobehav Rev. 2013;37(8):1824-37.
  2. Glisky EL. Changes in cognitive function in human aging. Dis Model Mech.. 2007:3-20.
  3. Smith-Ray RL, Hughes SL, Prohaska TR, Little DM, Jurivich DA, Hedeker D. Impact of cognitive training on balance and gait in older adults. J Gerontol B Psychol Sci Soc Sci. 2015;70(3):357-66.
  4. Saperstein AM, Kurtz MM. Current trends in the empirical study of cognitive remediation for schizophrenia. J Can Acad Child Adolesc Psychiatry. 2013;58(6):311-8.
  5. Wykes T, Spaulding WD. Thinking about the future cognitive remediation therapy—what works and could we do better? Schizophr Bull. 2011;37(suppl_2):S80-S90.
  6. Campos C, BF Rocha N, Lattari E, E Nardi A, Machado S. Exercise induced neuroplasticity to enhance therapeutic outcomes of cognitive remediation in schizophrenia: analyzing the Role of Brai Nderived Neurotrophic Factor. CNS & neurological disorders drug targets 2017;16(6):638-51.
  7. Eack SM, Pogue-Geile MF, Greenwald DP, Hogarty SS, Keshavan MS. Mechanisms of functional improvement in a 2-year trial of cognitive enhancement therapy for early schizophrenia. Psychol Mede. 2011;41(6):1253-61.
  8. Eack SM, Hogarty GE, Cho RY, Prasad KM, Greenwald DP, Hogarty SS, et al. Neuroprotective effects of cognitive enhancement therapy against gray matter loss in early schizophrenia: results from a 2-year randomized controlled trial. Ann Gen Psychiatry. 2010;67(7):674-82.
  9. Ramsay IS, Fryer S, Boos A, Roach BJ, Fisher M, Loewy R, et al. Response to targeted cognitive training correlates with change in thalamic volume in a randomized trial for early schizophrenia. Neuropsychopharmacology. 2018;43(3):590-7.
  10. Lussier M, Brouillard P, Bherer L. Limited benefits of heterogeneous dual-task training on transfer effects in older adults. J Gerontol B Psychol Sci Soc Sci. 2017;72(5):801-12.
  11. Verghese J, Mahoney J, Ambrose AF, Wang C, Holtzer R. Effect of cognitive remediation on gait in sedentary seniors. J. Gerontol. A Biol. Sci. Med. Sci. 2010;65(12):1338-43.
  12. Doumas M, Rapp MA, Krampe RT. Working memory and postural control: adult age differences in potential for improvement, task priority, and dual tasking. J Gerontol B Psychol Sci Soc Sci.. 2009;64(2):193-201.
  13. Li KZ, Roudaia E, Lussier M, Bherer L, Leroux A, McKinley P. Benefits of cognitive dual-task training on balance performance in healthy older adults. J. Gerontol. A Biol. Sci. Med. Sci. 2010;65(12):1344-52.
  14. Aubin G, Stip E, Gélinas I, Rainville C, Chapparo C. Daily activities, cognition and community functioning in persons with schizophrenia.Schizophr. Res. 2009;107(2-3):313-8.
  15. Peralta V, Campos MS, De Jalón EG, Cuesta MJ. Motor behavior abnormalities in drug‐naïve patients with schizophrenia spectrum disorders.Mov. Disord.. 2010;25(8):1068-76.
  16. Kring AM, Moran EK. Emotional response deficits in schizophrenia: insights from affective science. Schizophr Bull.. 2008;34(5):819-34.
  17. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98.
  18. Foroughan M, JAFARI Z, SHIRIN BP, GHAEM MFZ, RAHGOZAR M. Validation of mini-mental state examination (MMSE) in the elderly population of Tehran. 2008 [in Persian].
  19. Dadfar M, Kalibatseva Z. Psychometric properties of the Persian version of the short Beck Depression Inventory with Iranian psychiatric outpatients. Scientifica. 2016; [in Persian]
  20. SUZUKI T. Thresholds of physical activities necessary for living a self-supporting life in elderly women. Osaka City Med J. 2007;53:53-61.
  21. Fathi Rezaie Z, Aslankhani Ma, Abdoli B, Farsi A, Aghdasi Mt, Zamani sani H. The Comparison of Falling Risk of Elderly by Speed Gait Test Under Dual Tasks Conditions. Salmand: Iranian Journal of Ageing. 2010;5(2):1-258 [in Persian]-.
  22. Smith-Ray RL, Makowski-Woidan B, Hughes SL. A randomized trial to measure the impact of a community-based cognitive training intervention on balance and gait in cognitively intact black older adults. Health Educ Behav. 2014;41(1):62S-9S.
  23. Kesler SR, Lacayo NJ, Jo B. A pilot study of an online cognitive rehabilitation program for executive function skills in children with cancer-related brain injury. Brain Inj. 25(1)101-111
  24. Johnston MV, Ishida A, Ishida WN, Matsushita HB, Nishimura A, Tsuji M. Plasticity and injury in the developing brain. Brain Dev. 2009;31(1):1-10.
  25. Neely AS, Vikström S, Josephsson S. Collaborative memory intervention in dementia: caregiver participation matters. Neuropsychol Rehabil. 2009;19(5):696-715.
  26. Maghsoudloo M, Nejati V, Abadi F. The Effectiveness of Slow Cognitive Rehabilitation Package on Improving Executive Functions Based on Behavioral Assessments of Children with Pre-School Attention Deficit / Hyperactivity Disorder. Psychology of Exceptional People. 2019; 9 (33): 23-43. [in Persian].
  27. Nuechterlein KH, Dawson ME. Information processing and attentional functioning in the developmental course of schizophrenic disorders. Schizophr Bull. 1984;10(2):160-203.
  28. Hausdorff JM, Yogev G, Springer S, Simon ES, Giladi N. Walking is more like catching than tapping: gait in the elderly as a complex cognitive task. Exp Brain Res. 2005;164(4):541-8.
  29. Ble A, Volpato S, Zuliani G, Guralnik JM, Bandinelli S, Lauretani F, et al. Executive function correlates with walking speed in older persons: the InCHIANTI study. J Am Geriatr Soc. 2005;53(3):410-5.
  30. Liu-Ambrose TY, Ashe MC, Graf P, Beattie BL, Khan KM. Increased risk of falling in older community-dwelling women with mild cognitive impairment. Phys Ther 2008;88(12):1482-91.
  31. Doyon J, Bellec P, Amsel R, Penhune V, Monchi O, Carrier J, et al. Contributions of the basal ganglia and functionally related brain structures to motor learning. Behav. Brain Res 2009;199(1):61-75.
  32. Erickson KI, Colcombe SJ, Wadhwa R, Bherer L, Peterson MS, Scalf PE, et al. Training-induced plasticity in older adults: effects of training on hemispheric asymmetry. Neurobiol. Aging. 2007;28(2):272-83.
  33. Suzuki M, Miyai I, Ono T, Oda I, Konishi I, Kochiyama T, et al. Prefrontal and premotor cortices are involved in adapting walking and running speed on the treadmill: an optical imaging study. Neuroimage. 2004;23(3):1020-6.
  34. Alexander GE, DeLong MR, Strick PL. Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annu. Rev. Neurosci. 1986;9(1):357-81.