Fine Motor Serious Game Training Improves Gait in Parkinson s Disease: A Pilot Randomized Controlled Trial

Crucial functions for human behavior such as gross motor skills (e.g., walking), cognitive, rhythmic, and fine motor processes are mostly considered unrelated. However, these functions may interact, but their relations are still poorly understood. Moreover, evidence of causal links between them is scarce. Neurological disorders such as Parkinsons Disease affect all these functions and thus provide a model to study the interplay between them. We tested the effect of a training delivered using serious games on tablet, involving upper limb rhythmic and fine motor functions, on walking capacities in patients with Parkinsons Disease (PwPD). PwPD gathered into an Intervention group played either a rhythm game, or an adaptation of Tetris, four times a week for six weeks. Before and after the training, gait was evaluated in spontaneous walking and a dual task (counting backward while walking). A Control group of participants did not receive any training. Gait speed, stride length and cadence improved in the Intervention group after the training in comparison with the Control group. The improvement was observed in both Intervention groups, in the spontaneous and in the dual-task conditions. These findings support the hypothesis that gross (axial) motor functions can be trained by fine (lateralized) motor training administered via serious games, possibly by stimulating the rhythmic, perceptual, and cognitive resources sensory systems. This opening promising perspectives for telerehabilitation. Patients with movement disorders could benefit from this promising low-cost and engaging training method, fostering inclusivity and autonomy for people who have reduced access to the clinic.