The interactive Physical and Cognitive Exercise (iPACES) is a neuro-exergame that combines interactive cognitive gaming with physical exercise to target executive function for patients with mild cognitive impairment (MCI), the preclinical phase of Alzheimer’s disease. Prior studies found promising cognitive benefits from iPACES for the MCI population (Anderson-Hanley et al., 2018). This is a novel pilot study for iPACES with Parkison’s Disease patients, which is currently in clinical trials for MCI. Parkinson’s Disease (PD) with mild cognitive impairment (PD-MCI) presents with heterogeneity of motor and neuropsychological outcomes (Cammisuli et al., 2019). Patients with PD have requested participation with iPACES and clinics are searching for interventions for PD-MCI. The goal of the pilot is to understand if iPACES may afford any cognitive benefits for the PD-MCI population.
Patients with Parkinson’s from clinics in the USA will be invited to briefly pedal-n-play the iPACES neuro-exergame, paired with a portable under-desk elliptical pedaler. Participants will be instructed to play iPACES for 20 minutes, and will be evaluated with neuropsychological testing pre and post exercise to briefly understand any cognitive changes. The administration will be remotely administered, and electronic cognitive tests will be used for the evaluation. A previous feasibility study conducted in 2022 (n=15, average play time = 11 minutes; age = 74.3, SD = 9.8, range 51-90 yrs old) revealed some insight into the usability of iPACES components. Regarding the apparatus, 10 of 15 patients had no problems, four needed assistance, and a few had difficulty with the pedals. A number of suggestions were generated for improving the usability of iPACES for PD for the novel pilot study.
The novel iPACES neuro-exergame study for PD patients can give insight into whether iPACES can improve any of the cognitive deficits experienced by PD-MCI patients. The feasibility study revealed that the pilot study is possible, but adaptations are needed to address any equipment challenges. The use of electronic testing and remote administration in the pilot will inform if an at-home, long-term iPACES intervention is feasible for PD-MCI patients.
Anderson-Hanley, C., et al. The interactive Physical and Cognitive Exercise System (iPACESTM): effects of a 3-month in-home pilot clinical trial for mild cognitive impairment and caregivers. Clinical Interventions in Aging, 13, 1565–1577. https://doi.org/10.2147/cia.s160756
Cammisuli, S. M et al. (2019). Parkinson’s Disease–Mild Cognitive Impairment (PD-MCI): A Useful Summary of Update Knowledge. Frontiers in Aging Neuroscience, 11, 303–303. https://doi.org/10.3389/fnagi.2019.00303