The Effects of Dual Task Training With Different Task Priorities on Physical Performance and Cognitive Status in Patients With Parkinson's Disease

Primary outcomes

1. Hoehn and Yahr Scale

   Time frame: Baseline, 6 weeks

   A staging system that quickly provides information in determining the degree and symptom severity of the disease

2. Unified Parkinson's Disease Rating Scale

   Time frame: Baseline, 6 weeks

   Evaluates cognitive skills, mood, activities of daily living, motor skills, motor fluctuations, dyskinesias, and autonomic dysfunction in four parts

3. Berg Balance Scale

   Time frame: Baseline, 6 weeks

   It includes 14 functional activities to assess static and proactive balance. The total score ranges from 0 to 56, with higher scores indicating better balance.

4. Functional Reach Test

   Time frame: Baseline, 6 weeks

   The test is designed to assess dynamic balance by measuring the maximum distance that a person can reach forward beyond arm's length without taking a step.

5. Single Leg Stance Test

   Time frame: Baseline, 6 weeks

   It is a test method used to evaluate static balance. One foot is lifted without touching the supporting leg and the person is expected to maintain their balance for 30 seconds.

6. Four Square Step Test

   Time frame: Baseline, 6 weeks

   It is a test method used to evaluate dynamic balance. Two canes are placed on a flat surface to create 4 squares. All squares are numbered. The subject starts in one square and steps in one direction into each of the four squares and then reverses direction back to the start. The time (in seconds) taken to complete the sequence is measured.

7. 10 Meter Walk Test

   Time frame: Baseline, 6 weeks

   Used to assess walking speed. Participants are asked to walk a distance of 10 meters and the time taken is recorded.

8. Figure-of-Eight Walk Test

   Time frame: Baseline, 6 weeks

   The participant stands still at the midpoint of two cones placed 1.52 m apart and begins walking around the cones in a figure eight at his/her usual pace. The total time and number of steps taken to complete the test are recorded.

9. 3-Meter Backward Walk Test

   Time frame: Baseline, 6 weeks

   The 3-meter distance is measured and marked. Participants are asked to walk backwards as quickly as possible with the "walk" command and to stop when they reach 3 meters. The elapsed time is recorded in seconds.

10. Timed Up and Go Test

    Time frame: Baseline, 6 weeks

    It is used to assess functional mobility level. The participant is asked to stand up from the chair, walk 3 m, turn around, walk back to the chair and sit down. The test starts with the "walk" command and the completion time is recorded in seconds.

11. Unified Parkinson's Disease Rating Scale, Part 2

    Time frame: Baseline, 6 weeks

    UPDRS Part 2 generally is considered a psychometrically reliable tool for measuring activities of daily living outcomes in people with Parkinson's disease.

12. Dual Task Questionnaire

    Time frame: Baseline, 6 weeks

    It is used to obtain information about the difficulties experienced in daily tasks related to dual task. It consists of 10 questions, each question is scored between 0 and 4.

13. Trail Making Test

    Time frame: Baseline, 6 weeks

    It is used to evaluate individuals' visual scanning speed, executive functions, visual-motor perception, motor function, planning, organization, abstract thinking and response limitation. The test consists of 2 parts: A and B. In part A, the individual is asked to combine numbers from 1 to 25 and the completion time is recorded. In part B, the individual completes the sequence by corresponding to a number and a letter, and the completion time is recorded.

14. Stroop Test

    Time frame: Baseline, 6 weeks

    It is a test that evaluates executive functions and the suppression of inappropriate automatic responses and provides information about frontal functions.

15. Symbol Digit Modalities Test

    Time frame: Baseline, 6 weeks

    It is a test that measures working memory and information processing speed. In the upper right corner of the A4 paper used in the test, there is a grid of shapes, each representing a number. In the other parts of the paper, there are randomly arranged shapes in blocks. During the test, patients are asked to match these shapes with the numbers in the grid.

16. Word List Generation

    Time frame: Baseline, 6 weeks

    It is a test used to evaluate complex attention functions and vocabulary. It consists of animal and KAS sections. First, the patient is asked to name every animal that comes to mind in one minute, as quickly as possible. In the KAS section, the patient is asked to name every word that comes to mind, except for proper nouns and city names, with the letters K-A-S in order. The time for each letter is again one minute.

17. Tampa Scale for Kinesiophobia

    Time frame: Baseline, 6 weeks

    It is a 17-question scale developed to measure fear of movement/re-injury. The scale includes parameters of injury/re-injury and fear-avoidance in work-related activities. Each item is scored between 1-4.