
{"id":748398,"date":"2026-07-22T12:29:07","date_gmt":"2026-07-22T10:29:07","guid":{"rendered":"https:\/\/www.dynseo.com\/fonctions-executives-et-parkinson-exercices-pratiques-pour-les-preserver-dynseo-2\/"},"modified":"2026-07-22T12:32:49","modified_gmt":"2026-07-22T10:32:49","slug":"executive-functions-and-parkinsons-practical-exercises-to-preserve-them","status":"publish","type":"post","link":"https:\/\/www.dynseo.com\/en\/executive-functions-and-parkinsons-practical-exercises-to-preserve-them\/","title":{"rendered":"Executive Functions and Parkinson&#8217;s: Practical Exercises to Preserve Them"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;Article HTML&#8221; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row admin_label=&#8221;Contenu&#8221; _builder_version=&#8221;4.16&#8243; width=&#8221;100%&#8221; max_width=&#8221;100%&#8221; 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{background:#fff;border-radius:var(--br);padding:20px 18px;box-shadow:var(--shc);border-top:3px solid var(--teal)}\n.dbi-art-a11be9 .fe-exo.pink-t {border-top-color:var(--pink)}\n.dbi-art-a11be9 .fe-exo.blue-t {border-top-color:var(--blue)}\n.dbi-art-a11be9 .fe-exo.yellow-t {border-top-color:#c49000}\n.dbi-art-a11be9 .fe-exo h5 {font-family:'Montserrat',sans-serif;font-size:13px;font-weight:700;color:var(--blue-dark);margin-bottom:8px}\n.dbi-art-a11be9 .fe-exo p {font-size:12px;color:var(--text-light);margin:0 0 8px;line-height:1.55}\n.dbi-art-a11be9 .fe-exo .fe-meta {display:flex;gap:6px;flex-wrap:wrap;margin-top:6px}\n.dbi-art-a11be9 .fe-badge {font-size:10px;font-weight:700;padding:2px 8px;border-radius:50px;background:var(--light-bg);color:var(--text-light)}\n.dbi-art-a11be9 .schedule-row {display:grid;grid-template-columns:140px 1fr 80px;gap:12px;padding:12px 16px;border-radius:8px;margin-bottom:8px;font-size:13px;align-items:center}\n.dbi-art-a11be9 .schedule-row:nth-child(odd) {background:var(--light-bg)}\n.dbi-art-a11be9 .schedule-row:nth-child(even) {background:#fff;box-shadow:var(--shc)}\n.dbi-art-a11be9 .schedule-row .sr-time {font-weight:700;color:var(--blue-dark)}\n.dbi-art-a11be9 .schedule-row .sr-label {font-size:11px;color:#1a6e50;font-weight:700;text-align:right}<\/p>\n<\/style>\n<div class=\"dbi-art-a11be9\">\n<header class=\"hero\">\n<div class=\"hero-tag\">\ud83e\udde0 Parkinson \u00b7 Executive functions \u00b7 Preservation program \u00b7 Neuropsychology<\/div>\n<h1>Executive functions and Parkinson&#8217;s: practical exercises to preserve them<\/h1>\n<pee class=\"hero-sub\">Parkinson&#8217;s disease affects executive functions from early stages \u2014 planning, flexibility, inhibition, working memory, attention. This program of 20 targeted exercises, adapted to the specifics of Parkinson&#8217;s, helps preserve them and maintain autonomy longer.<\/pee>\n<\/header>\n<p><main class=\"container\"><\/p>\n<div class=\"intro-box\"><pee>Parkinson&#8217;s disease is known for its motor symptoms \u2014 tremors, rigidity, bradykinesia. But beyond the motor picture, another neuropsychological terrain gradually erodes, often silently: <strong>executive functions<\/strong>. These high-level abilities \u2014 planning a sequence of actions, adapting when rules change, resisting an impulse, maintaining multiple pieces of information in mind simultaneously \u2014 are precisely those upon which daily autonomy depends. Preparing in the morning, managing medications, cooking a meal, managing one&#8217;s schedule: all these activities mobilize executive functions. This guide offers a program of 20 practical exercises organized by executive function, specifically designed for the constraints of Parkinson&#8217;s disease \u2014 adapted to on\/off fluctuations, accessible despite motor symptoms, and progressive to follow each patient&#8217;s evolution.<\/pee><\/div>\n<h2>1. Executive functions in Parkinson&#8217;s disease<\/h2>\n<h3>1.1 Why Parkinson&#8217;s specifically affects executive functions<\/h3>\n<pee>Executive functions (EF) are primarily underpinned by the <strong>prefrontal cortex<\/strong> and its connections with the basal ganglia \u2014 the central gray nuclei at the heart of Parkinsonian pathology. Parkinson&#8217;s disease causes dopaminergic depletion in the nigrostriatal circuits that govern not only motor control but also the frontostriatal loops involved in EF. From the early stages of the disease, even before motor disorders become disabling, subtle deficits in executive functions can be detected by sensitive neuropsychological tests.<\/pee>\n<pee>These Parkinsonian executive deficits have a characteristic profile: they primarily affect <strong>cognitive flexibility<\/strong> (difficulty in changing strategy or adapting to new rules), <strong>verbal fluency<\/strong> (notably generation fluency), <strong>planning<\/strong> (difficulty organizing complex action sequences), and <strong>working memory<\/strong> (reducing the ability to maintain and manipulate multiple pieces of information simultaneously). These deficits are distinct from those observed in Alzheimer&#8217;s disease \u2014 where episodic memory is primarily affected \u2014 which explains why people with Parkinson&#8217;s may have difficulty planning a trip while perfectly remembering their last birthday.<\/pee>\n<div class=\"stats-grid\">\n<div class=\"stat-card blue\">\n    <span class=\"stat-num\">50\u201370 %<\/span><br \/>\n    <span class=\"stat-label\">of Parkinson&#8217;s patients exhibit measurable executive deficits from early stages (Aarsland et al., 2017)<\/span>\n  <\/div>\n<div class=\"stat-card teal\">\n    <span class=\"stat-num\">3\u20135 years<\/span><br \/>\n    <span class=\"stat-label\">in advance: executive deficits often precede memory deficits in Parkinson&#8217;s, unlike in Alzheimer&#8217;s<\/span>\n  <\/div>\n<div class=\"stat-card pink\">\n    <span class=\"stat-num\">+40 %<\/span><br \/>\n    <span class=\"stat-label\">improvement in EF among Parkinson&#8217;s patients following a combined cognitive stimulation + physical activity program vs. control (Cruise et al., 2021)<\/span>\n  <\/div>\n<div class=\"stat-card yellow\">\n    <span class=\"stat-num\">5 EFs<\/span><br \/>\n    <span class=\"stat-label\">primarily affected: planning, flexibility, inhibition, working memory, divided attention \u2014 specific program for each<\/span>\n  <\/div>\n<\/div>\n<h3>1.2 The clinical picture: how executive deficits manifest in daily life<\/h3>\n<pee>Parkinsonian executive deficits do not always manifest obviously during ordinary conversation \u2014 which is why they are often underestimated by the patients themselves and by those around them. They become apparent during tasks that require complex organization, rapid adaptation, or simultaneous management of multiple pieces of information.<\/pee>\n<table class=\"dynseo-table\">\n<thead>\n<tr>\n<th>Executive function<\/th>\n<th>Deficit in Parkinson&#8217;s<\/th>\n<th>Daily manifestation<\/th>\n<th>Impact on autonomy<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><strong>Planning<\/strong><\/td>\n<td><span class=\"badge badge-pink\">Moderate to severe<\/span><\/td>\n<td>Difficulty organizing a sequence of actions (recipe, route), forgetting steps<\/td>\n<td>Cooking, managing medications, preparing outings<\/td>\n<\/tr>\n<tr>\n<td><strong>Cognitive flexibility<\/strong><\/td>\n<td><span class=\"badge badge-pink\">Affected early<\/span><\/td>\n<td>Perseveration on a strategy even when it no longer works, difficulty changing topics or tasks<\/td>\n<td>Adapting to unforeseen events, social conversations, driving<\/td>\n<\/tr>\n<tr>\n<td><strong>Inhibition<\/strong><\/td>\n<td><span class=\"badge badge-yellow\">Variable<\/span><\/td>\n<td>Tendency to complete automatic movements (paradoxical freeze), impulsive responses, difficulty ignoring distractors<\/td>\n<td>Safety at home, managing impulsive purchases, conversations<\/td>\n<\/tr>\n<tr>\n<td><strong>Working memory<\/strong><\/td>\n<td><span class=\"badge badge-pink\">Moderate<\/span><\/td>\n<td>Loses track of a conversation, forgets what they were doing when moving from one room to another, difficulty doing two things at once<\/td>\n<td>Dual tasking, managing the agenda, following conversations<\/td>\n<\/tr>\n<tr>\n<td><strong>Divided attention<\/strong><\/td>\n<td><span class=\"badge badge-pink\">Affected early<\/span><\/td>\n<td>Marked difficulties sharing attention between two simultaneous tasks \u2014 particularly the dual task of walking + talking<\/td>\n<td>Safety while walking, cooking, conversation during an activity<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3>1.3 The dual task: a specific challenge of Parkinson&#8217;s<\/h3>\n<pee>One of the most specific and well-documented manifestations of executive deficits in Parkinson&#8217;s is the difficulty with <strong>dual tasks<\/strong> \u2014 performing two activities simultaneously. A well-known phenomenon among clinicians is the deterioration of walking when the patient talks at the same time: the conversation absorbs attentional resources that should be available for the automatic regulation of walking, leading to slowing, instability, or even freezing. This is not ordinary distraction \u2014 it is a direct manifestation of the frontal executive deficit in managing limited attentional resources.<\/pee>\n<pee>This peculiarity has an important implication for the exercise program: stimulating EF in Parkinson&#8217;s patients must include progressive dual task exercises, but always ensuring physical safety \u2014 never during fast walking or on uneven terrain in moderate or advanced stages.<\/pee>\n<div class=\"teal-box\"><pee>\ud83e\udde0 <strong>Parkinson&#8217;s specificity:<\/strong> Unlike general cognitive stimulation programs, a specific program for Parkinson&#8217;s must systematically take into account the on\/off windows of dopaminergic treatment. The most cognitively demanding exercises (flexibility, inhibition, dual task) should be planned during &#8220;on&#8221; phases \u2014 that is, 30 to 90 minutes after taking medication. Softer exercises (simple planning, autobiographical anchoring) can be practiced during periods of lower treatment effectiveness.<\/pee><\/div>\n<h2>2. Program of 20 exercises by executive function<\/h2>\n<p><!-- EF 1: PLANNING --><\/p>\n<div class=\"fe-section\">\n<div class=\"fe-section-header\">\n<div class=\"fe-icon\">\ud83d\uddfa\ufe0f<\/div>\n<div>\n<h3>FE 1 \u2014 Sequential Planning<\/h3>\n<p>      <span>Organize a sequence of actions to achieve a goal \u00b7 Exercises 1\u20134<\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"fe-exo-grid\">\n<div class=\"fe-exo\">\n<h5>Planning the Day in Time Slots<\/h5>\n<pee>Every morning, plan the day by noting 4 to 6 activities with their estimated time and optimal order. At the end of the day, compare plan and realization: what was modified? Why? This meta-planning reflection strengthens the prefrontal circuits of planning while remaining close to real life.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Accessible<\/span><span class=\"fe-badge\">\ud83d\uddd3\ufe0f Functional<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo\">\n<h5>Simplified Tower of Hanoi<\/h5>\n<pee>Version with 3 disks of the classic game (available in physical version or free app): move all disks from one peg to another while respecting the rule (never a large disk on a small one). Requires planning of at least 7 moves. Start with 3 disks, aim for 4. Excellent tree planning exercise.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 10 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\u265f\ufe0f Strategy<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo\">\n<h5>Imaginary Route<\/h5>\n<pee>Choose a known route (going to the pharmacy, to the market) and plan it verbally out loud in the exact order: starting points, route, stops, order of purchases to optimize the journey, return. Then repeat with a less familiar route. Strengthens spatial and sequential planning.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83d\uddfa\ufe0f Visuo-spatial<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo\">\n<h5>Mental Recipe<\/h5>\n<pee>Choose a familiar recipe and mentally reconstruct all the steps in the exact order \u2014 with the ingredients, durations, order of using the equipment. Then check with the actual recipe. Difficult variant: plan two simultaneous dishes while managing overlapping cooking times. Very close to the daily requirements of autonomy.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 10 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate to Challenging<\/span><span class=\"fe-badge\">\ud83c\udf73 Functional<\/span><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n<p><!-- FE 2: FLEXIBILITY --><\/p>\n<div class=\"fe-section-header\">\n<div class=\"fe-icon\">\ud83d\udd00<\/div>\n<div>\n<h3>FE 2 \u2014 Cognitive Flexibility<\/h3>\n<p>      <span>Adapting when the rules change \u00b7 Exercises 5\u20138<\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"fe-exo-grid\">\n<div class=\"fe-exo pink-t\">\n<h5>Alternating Sorting Task (Simplified DCCS)<\/h5>\n<pee>Sort image cards by color for 2 minutes, then change the rule (sort by shape, or by the number of items) on signal. The exercise is difficult not because of the rules themselves, but because of the need to inhibit the previous rule. Repeat the alternation 4 to 6 times during the session.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 10 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83c\udccf Manipulative<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo pink-t\">\n<h5>Alternating News Reading<\/h5>\n<pee>Read a newspaper article, then immediately give the opposite opinion orally to that expressed in the article. This perspective reversal exercise engages cognitive flexibility and theory of mind. Start with neutral topics (sports, culture), progress to more complex topics (politics, society).<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Stimulating<\/span><span class=\"fe-badge\">\ud83d\udcac Verbal<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo pink-t\">\n<h5>Fluency by Alternating Categories<\/h5>\n<pee>Name alternately an animal, then a piece of furniture, then an animal, then a piece of furniture (etc.) for 3 minutes. The alternation constraint \u2014 changing category with each item \u2014 directly tests cognitive flexibility and verbal fluency, both affected in Parkinson&#8217;s. Difficult variant: 3 categories in rotation.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 5 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83d\udde3\ufe0f Verbal<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo pink-t\">\n<h5>Contextual Opposites Game<\/h5>\n<pee>Give the antonym of randomly presented words (fast\/slow, big\/small) \u2014 easy exercise. Then reverse: each time a word is presented, give a synonym EXCEPT for color words (give the antonym). This change of contextual rule mimics daily challenges of adapting to changing rules.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Stimulating<\/span><span class=\"fe-badge\">\ud83e\udde9 Cognitive<\/span><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n<p><!-- FE 3: INHIBITION --><\/p>\n<div class=\"fe-section\">\n<div class=\"fe-section-header\">\n<div class=\"fe-icon\">\ud83d\uded1<\/div>\n<div>\n<h3>FE 3 \u2014 Inhibition and response control<\/h3>\n<p>      <span>Resist an automatic response \u00b7 Exercises 9\u201312<\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"fe-exo-grid\">\n<div class=\"fe-exo blue-t\">\n<h5>Simplified oral Stroop<\/h5>\n<pee>The adult presents color words written in a different ink (the word &#8220;RED&#8221; written in blue). The patient must name the color of the ink \u2014 not the written word. Resisting the impulse to read the word is the main difficulty. Start slowly, without time constraints, progressing to a faster pace.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 5 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83d\udc41\ufe0f Visual-verbal<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo blue-t\">\n<h5>Vocal Stop-and-Go<\/h5>\n<pee>The patient recites the days of the week or the months. On signal (hand raised or noise), they stop immediately. On a second signal, they resume where they left off. Inhibiting a well-learned automatic sequence is particularly relevant in Parkinson&#8217;s (freezing). Repeat 8 to 10 times during the session.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 5 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Easy<\/span><span class=\"fe-badge\">\ud83d\udde3\ufe0f Sequential<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo blue-t\">\n<h5>Inverted Yes-No<\/h5>\n<pee>Ask questions to which the natural response would be &#8220;yes&#8221; \u2014 the patient must respond &#8220;no&#8221; and vice versa. &#8220;Is it dark right now? (no) \u2192 respond yes.&#8221; A simple and playful inhibition exercise, easily doable at home or in session. Progress to more complex questions.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 5 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Easy<\/span><span class=\"fe-badge\">\ud83d\udcac Playful<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo blue-t\">\n<h5>Selective reading with inhibition criterion<\/h5>\n<pee>Read a short text while skipping all words from a defined category (e.g., skip all color words, or all animal names) without saying them aloud. Inhibiting specific words in a continuous reading flow is an advanced form of the inhibition exercise, closer to daily cognitive demands.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Challenging<\/span><span class=\"fe-badge\">\ud83d\udcda Reading<\/span><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n<p><!-- FE 4: WORKING MEMORY --><\/p>\n<div class=\"fe-section\">\n<div class=\"fe-section-header\">\n<div class=\"fe-icon\">\ud83d\udcbe<\/div>\n<div>\n<h3>FE 4 \u2014 Working Memory<\/h3>\n<p>      <span>Maintain and manipulate short-term information \u00b7 Exercises 13\u201316<\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"fe-exo-grid\">\n<div class=\"fe-exo yellow-t\">\n<h5>Reverse Digit Span<\/h5>\n<pee>The caregiver or speech therapist states a series of digits (starting with 3) that the patient repeats in reverse. E.g.: \u201c4 \u2013 7 \u2013 2\u201d \u2192 respond \u201c2 \u2013 7 \u2013 4\u201d. Gradually increase the length of the series. This is the working memory exercise most directly correlated with daily life performance in Parkinson&#8217;s patients.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 5 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83d\udd22 Verbal<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo yellow-t\">\n<h5>Multi-step Message<\/h5>\n<pee>Memorize 3 to 4 actions to be performed in order in different rooms (e.g.: \u201c1. Place a book in the bedroom, 2. Turn off the hallway light, 3. Return by taking the longest route\u201d). Prospective and spatial working memory is one of the most functionally important in daily life for Parkinson&#8217;s patients.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83c\udfc3 Functional<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo yellow-t\">\n<h5>Series Mental Calculation<\/h5>\n<pee>Start at 100, subtract 7 each time: 100, 93, 86, 79&#8230; Maintaining the current result while calculating the next subtraction is a double demand on working memory. Adjust according to the level (subtract 3 for ease, subtract 7 for standard difficulty, 13 for a challenge).<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 5 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83d\udd22 Calculation<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo yellow-t\">\n<h5>Delayed Reading Summary<\/h5>\n<pee>Read a short text (10 lines), set the text aside, wait 5 minutes (during which another activity is performed), then summarize the text from memory \u2014 main ideas, retained details, opinion. The voluntary interference between encoding and recall simulates the distractions of daily life that disrupt working memory in Parkinson&#8217;s patients.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 12 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Stimulating<\/span><span class=\"fe-badge\">\ud83d\udcda Delayed Recall<\/span><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n<p><!-- FE 5: DIVIDED ATTENTION --><\/p>\n<div class=\"fe-section\">\n<div class=\"fe-section-header\">\n<div class=\"fe-icon\">\ud83c\udfaf<\/div>\n<div>\n<h3>FE 5 \u2014 Divided attention and secure dual task<\/h3>\n<p>      <span>Share attention between two tasks \u00b7 Exercises 17\u201320 \u00b7 Safety first<\/span>\n    <\/div>\n<\/p><\/div>\n<pee style=\"font-size:13px;color:var(--text-light);margin-bottom:16px\">\u26a0\ufe0f These exercises should never be performed while walking on uneven ground or in a fall-risk situation. Always seated or standing stable, on flat and clear ground for motor variants.<\/pee>\n<div class=\"fe-exo-grid\">\n<div class=\"fe-exo\">\n<h5>Seated dual task: counting + sorting<\/h5>\n<pee>Seated, sort colored cards with one hand while the other taps a steady rhythm on the table. Then switch hands. Next, sort the cards while counting aloud backwards from 20. This seated dual task is secure and directly targets central attentional sharing.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\u2705 Secure<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo\">\n<h5>Rhythmic walking with counting (flat ground, accompanied)<\/h5>\n<pee>On flat, clear ground, accompanied by a relative or a physiotherapist: walk while counting aloud by 2s. Start with 30-second periods, gradually increasing. The goal is not speed but the simultaneous maintenance of walking AND counting. Stop as soon as the gait deteriorates.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 10 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Stimulating<\/span><span class=\"fe-badge\">\ud83d\udeb6 Accompanied<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo\">\n<h5>Conversation during a simple manual task<\/h5>\n<pee>Perform a simple and automated manual task (folding laundry, sorting coins) while maintaining a normal conversation with a relative. Deliberately shift the main attention from the task to the conversation and vice versa. Exercise close to the most demanding daily situations in terms of divided attention.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 10 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83c\udfe0 Daily life<\/span><\/div>\n<\/p><\/div>\n<div class=\"fe-exo\">\n<h5>Reading aloud + sensory monitoring<\/h5>\n<pee>Read a text aloud while being simultaneously attentive to the sounds of the environment \u2014 signal each time a particular sound (bird, car, clock) is heard. Exercise of auditory-visual divided attention that involves no motor risk and can be practiced independently.<\/pee>\n<div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83d\udd0a Sensory<\/span><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n<h2>3. Adapt the program to Parkinson&#8217;s fluctuations<\/h2>\n<h3>3.1 Understand and use on\/off windows<\/h3>\n<pee>The vast majority of Parkinson&#8217;s patients treated with levodopa experience fluctuations in treatment effectiveness throughout the day. &#8220;On&#8221; periods \u2014 when the treatment is effective \u2014 offer better mobility, greater energy, and optimized cognitive abilities. &#8220;Off&#8221; periods \u2014 at the end of treatment effectiveness \u2014 are accompanied by motor and cognitive slowing, increased fatigue, and sometimes dysphoria. Adapting the executive function stimulation program to this cycle is essential to maximize its effectiveness and to avoid counterproductive sessions conducted during periods of low cognitive availability.<\/pee>\n<div class=\"process-track\">\n<div class=\"process-step\">\n<div class=\"ps-standard\">\n      <span class=\"ps-label\">\ud83d\udd34 OFF period or cognitive fatigue<\/span><\/p>\n<h5>Not recommended exercises<\/h5>\n<pee>Dual task, Stroop, Tower of Hanoi, mental calculation in series \u2014 these demanding exercises during reduced effectiveness periods generate frustration, errors, and can discourage the continuation of the program.<\/pee>\n    <\/div>\n<div class=\"ps-adapted\">\n      <span class=\"ps-label\">\u2705 Exercises adapted to the OFF period<\/span><\/p>\n<h5>Light and maintenance exercises<\/h5>\n<pee>Planning the day, simple mental recipe, gentle thematic conversation, emotional recognition exercises (Facial Expression Decoder). These activities maintain cognitive engagement without overloading.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"process-step\">\n<div class=\"ps-standard\">\n      <span class=\"ps-label\">\ud83d\udfe2 Optimal ON period<\/span><\/p>\n<h5>Ideal window for demanding exercises<\/h5>\n<pee>30 to 90 minutes after taking the treatment: this is the ideal time for flexibility, inhibition, dual task, and intensive working memory exercises. Plan the most ambitious sessions at these times.<\/pee>\n    <\/div>\n<div class=\"ps-adapted\">\n      <span class=\"ps-label\">\u2705 Recommended sequence during ON period<\/span><\/p>\n<h5>Complete program of 25-30 minutes<\/h5>\n<pee>5 min heart coherence (activation) \u2192 8 min demanding EF exercise (flexibility or inhibition) \u2192 8 min moderate EF exercise (working memory) \u2192 5 min gentle exercise (planning or emotional recognition) \u2192 assessment.<\/pee>\n    <\/div>\n<\/p><\/div>\n<\/div>\n<h3>3.2 The role of the Facial Expression Decoder in Parkinson&#8217;s<\/h3>\n<pee>A often overlooked deficit in Parkinson&#8217;s disease is the difficulty in recognizing and interpreting the emotional expressions of others \u2014 a disorder related to hypomimia (reduction of the patient&#8217;s own facial expressions) and changes in amygdaloid and striatal circuits. This social cognition deficit has direct consequences on daily interactions: the patient may miss important emotional signals in a conversation, leading to misunderstandings and gradual social withdrawal.<\/pee>\n<pee>Daily exercise with the <a href=\"https:\/\/www.dynseo.com\/en\/our-tools\/facial-expression-decoder\/\">DYNSEO Facial Expression Decoder<\/a> \u2014 identifying and naming emotions on photographed faces \u2014 is a direct and targeted training of this ability. It can be integrated into the EF stimulation program as an exercise of social attention and recognition of non-verbal cues, particularly suited for periods of cognitive fatigue as it does not require complex verbal production.<\/pee>\n<h2>3 bis. Integrate EF into daily activities<\/h2>\n<h3>Ordinary activities as a continuous stimulation ground<\/h3>\n<pee>Beyond structured exercise sessions, daily life itself offers permanent opportunities for executive function stimulation \u2014 provided they are approached deliberately and consciously. For Parkinson&#8217;s patients, whose windows of cognitive availability are limited, maximizing the impact of each ordinary activity is as important a strategy as formal exercises.<\/pee>\n<pee>The <strong>meal preparation<\/strong> is one of the richest domestic activities in terms of executive stimulation: planning (defining the order of preparations), flexibility (adapting if an ingredient is missing), working memory (remembering the steps completed and upcoming), inhibition (resisting tasting before finishing), and divided attention (monitoring cooking while preparing something else). Encouraging the patient to prepare their own meal for as long as possible \u2014 with safety adaptations if necessary \u2014 is an invaluable daily executive exercise.<\/pee>\n<pee>The <strong>medication management<\/strong> is another central executive activity for Parkinson&#8217;s patients: noting their doses, planning times according to meals, anticipating restocking, adapting if a pill has been forgotten. Using a weekly pill organizer, a displayed tracking chart, or a reminder app is not a capitulation to the disease \u2014 it is an executive compensation strategy that frees cognitive resources for other more stimulating activities.<\/pee>\n<pee>The <a href=\"https:\/\/www.dynseo.com\/en\/our-tools\/choice-wheel-outils-formation-dynseo\/\">DYNSEO Wheel of Choices<\/a> makes perfect sense here: faced with Parkinsonian apathy that can paralyze initiative (\u201cI don\u2019t know what to do, so I do nothing\u201d), the wheel of choices visually offers options for cognitively stimulating activities \u2014 gardening, reading, calling a friend, preparing a recipe. Each small act of decision and initiation exercises the prefrontal circuits against apathy, gradually preserving decision-making autonomy.<\/pee>\n<h2>4. DYNSEO tools to support the program<\/h2>\n<div class=\"formation-block\">\n<div class=\"fb-body\">\n<div class=\"fb-tag\">\ud83c\udf93 Certified training \u00b7 Qualiopi No. 11757351875<\/div>\n<h3>Behavioral changes related to the disease \u2014 Practical guide for relatives<\/h3>\n<pee>Daily support for a person with Parkinson&#8217;s requires understanding not only motor symptoms but also cognitive and behavioral changes related to executive deficits. This Qualiopi certified training provides family caregivers with neurobiological markers, adapted communication strategies, and tools to maintain their own balance in this demanding role.<\/pee>\n<div class=\"fb-meta\">\n      <span>\ud83d\udc68\u200d\ud83d\udc69\u200d\ud83d\udc67 Families and caregivers of Parkinson&#8217;s patients<\/span><br \/>\n      <span>\ud83d\udcbb 100% online, at your own pace<\/span><br \/>\n      <span>\ud83c\udfc6 Qualiopi certified<\/span><br \/>\n      <span>\ud83e\udde0 Accessible neurological approach<\/span>\n    <\/div>\n<p>    <a href=\"https:\/\/www.dynseo.com\/en\/?post_type=courses&#038;p=430733\" class=\"btn-primary\">Discover the training \u2192<\/a>\n  <\/div>\n<\/div>\n<h3>DYNSEO practical tools<\/h3>\n<div class=\"tools-grid\">\n<div class=\"tool-card\">\n<h5>\ud83c\udf21\ufe0f Emotion thermometer<\/h5>\n<pee>Assess emotional state and cognitive fatigue before each session \u2014 essential for choosing the appropriate exercise level according to the day&#8217;s on\/off windows.<\/pee>\n    <a href=\"https:\/\/www.dynseo.com\/en\/our-tools\/emotion-thermometer\/\">Download \u2192<\/a>\n  <\/div>\n<div class=\"tool-card\">\n<h5>\ud83c\udfa1 Wheel of choices<\/h5>\n<pee>Support decision-making autonomy weakened by Parkinsonian apathy \u2014 choosing the exercise of the day from available options maintains personal initiative and engagement in the program.<\/pee>\n    <a href=\"https:\/\/www.dynseo.com\/en\/our-tools\/choice-wheel-outils-formation-dynseo\/\">Download \u2192<\/a>\n  <\/div>\n<div class=\"tool-card\">\n<h5>\ud83d\ude0a Facial Expression Decoder<\/h5>\n<pee>Exercise 18 of the program \u2014 trains the recognition of emotions on faces, a capacity diminished in Parkinson&#8217;s with real social consequences. Accessible even during periods of cognitive fatigue.<\/pee>\n    <a href=\"https:\/\/www.dynseo.com\/en\/our-tools\/facial-expression-decoder\/\">Download \u2192<\/a>\n  <\/div>\n<div class=\"tool-card\">\n<h5>\ud83d\udd0a Complex sounds pictogram<\/h5>\n<pee>Progressive cognitive auditory training \u2014 stimulates sound recognition and auditory attention, important complements to the specific divided attention program for Parkinson&#8217;s.<\/pee>\n    <a href=\"https:\/\/www.dynseo.com\/en\/our-tools\/imagier-of-complex-sounds\/\">Download \u2192<\/a>\n  <\/div>\n<div class=\"tool-card\">\n<h5>\ud83d\udde3\ufe0f Articulation tracking chart<\/h5>\n<pee>Dysarthria (speech disorders) is common in Parkinson&#8217;s and affects communication during verbal exercises. This chart allows tracking of articulation progress and coordination with the speech therapist.<\/pee>\n    <a href=\"https:\/\/www.dynseo.com\/en\/our-tools\/articulatory-tracking-chart\/\">Download \u2192<\/a>\n  <\/div>\n<\/div>\n<pee>\u2192 <a href=\"https:\/\/www.dynseo.com\/en\/our-tools\/\">See all DYNSEO tools<\/a><\/pee>\n<h3>DYNSEO applications for cognitive stimulation<\/h3>\n<div class=\"appli-grid\">\n<div class=\"appli-card\">\n<h5>\ud83d\udc74 SCARLETT \u2014 Seniors &amp; Parkinson<\/h5>\n<pee>Cognitive stimulation application for seniors designed with a touch interface adapted to Parkinsonian motor difficulties. Personalized pathways for EF and memory. Usable independently or with support.<\/pee>\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/scarlett-brain-games-for-seniors\/\">Learn more \u2192<\/a>\n  <\/div>\n<div class=\"appli-card\">\n<h5>\ud83e\udde0 CLINT \u2014 Adults<\/h5>\n<pee>Cognitive remediation pathways for adults \u2014 adaptive exercises on memory, attention, and reasoning. Ideal for early and intermediate stage Parkinson&#8217;s patients, as a complement to the EF program.<\/pee>\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/clint-brain-games-for-adults\/\">Learn more \u2192<\/a>\n  <\/div>\n<div class=\"appli-card\">\n<h5>\ud83d\udcac MY DICTIONARY \u2014 Communication<\/h5>\n<pee>For Parkinson&#8217;s patients developing severe verbal expression difficulties (advanced dysarthria, Parkinsonian aphasia) \u2014 maintain communication despite language disorders.<\/pee>\n    <a href=\"https:\/\/www.dynseo.com\/mon-dico-une-application-pour-favoriser-la-communication\/\">Learn more \u2192<\/a>\n  <\/div>\n<div class=\"appli-card\">\n<h5>\ud83e\udd16 DYNSEO AI Coach<\/h5>\n<pee>Personalized support to guide patients and relatives in choosing exercises adapted to the on\/off windows, disease stage, and identified specific deficits.<\/pee>\n    <a href=\"https:\/\/www.dynseo.com\/en\/coach-ia-english\/\">Learn more \u2192<\/a>\n  <\/div>\n<\/div>\n<h3>DYNSEO cognitive tests<\/h3>\n<div class=\"formations-links\">\n<div class=\"formation-link\">\n    <span>Non-medical test \u00b7 Online assessment<\/span><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/memory-test\/\">DYNSEO memory test<\/a>\n  <\/div>\n<div class=\"formation-link\">\n    <span>Non-medical test \u00b7 Online assessment<\/span><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/concentration-and-attention-test\/\">Concentration and attention test<\/a>\n  <\/div>\n<div class=\"formation-link\">\n    <span>Non-medical test \u00b7 Online assessment<\/span><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/executive-function-testing\/\">Executive functions test<\/a>\n  <\/div>\n<\/div>\n<pee>\u2192 <a href=\"https:\/\/www.dynseo.com\/en\/our-tests\/\">Access all DYNSEO cognitive tests<\/a><\/pee>\n<h3>DYNSEO training<\/h3>\n<div class=\"formations-links\">\n<div class=\"formation-link\">\n    <span>For families and caregivers of Parkinson&#8217;s patients<\/span><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/?post_type=courses&#038;p=430733\">Behavioral changes \u2014 Practical guide for relatives<\/a>\n  <\/div>\n<div class=\"formation-link\">\n    <span>For health and care professionals<\/span><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/courses\/behavioral-disorders-related-to-illness-methods-and-multidisciplinary-coordination-en\/\">Behavioral disorders \u2014 Methods and multidisciplinary coordination<\/a>\n  <\/div>\n<\/div>\n<pee>\u2192 <a href=\"https:\/\/www.dynseo.com\/en\/our-training-courses\/\">See the complete DYNSEO training catalog<\/a><\/pee>\n<div class=\"cta-block\">\n<h3>\ud83e\udde0 Preserve your executive functions with DYNSEO<\/h3>\n<pee>SCARLETT and CLINT for daily stimulation, the 5 practical DYNSEO tools (Thermometer, Wheel of choices, Decoder, Pictogram, Articulation chart) and the Qualiopi certified training for relatives \u2014 a complete program to maintain autonomy and quality of life in Parkinson&#8217;s disease.<\/pee>\n<div class=\"btns\">\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/scarlett-brain-games-for-seniors\/\" class=\"btn-white\">Discover SCARLETT \u2192<\/a><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/executive-function-testing\/\" class=\"btn-outline\">Test my EF<\/a>\n  <\/div>\n<\/div>\n<p><\/main><\/p>\n<section class=\"faq-section\">\n<div class=\"container\">\n<h2>\u2753 FAQ \u2014 Executive functions and Parkinson&#8217;s disease<\/h2>\n<div class=\"faq-item\">\n<h4>1. What is the difference between memory deficits in Parkinson&#8217;s and those in Alzheimer&#8217;s?<\/h4>\n<pee>The difference is fundamental and clinically important. In Alzheimer&#8217;s disease, it is recent episodic memory that is affected first \u2014 the person forgets recent events irreversibly. In Parkinson&#8217;s disease, it is first working memory and executive functions that are affected \u2014 the person has difficulty organizing and planning, but can often remember recent facts if provided with retrieval cues. The neuropsychological profile is distinct enough to require different assessments and stimulation programs, even though both can coexist in advanced stages.<\/pee>\n    <\/div>\n<div class=\"faq-item\">\n<h4>2. Are these exercises compatible with levodopa treatment?<\/h4>\n<pee>Yes \u2014 and they are more effective in combination with optimized treatment. Dopaminergic treatment improves executive functions by partially restoring fronto-striatal circuits. Complementary cognitive stimulation acts on other mechanisms \u2014 neuroplasticity, strengthening of alternative circuits, improvement of cognitive reserve \u2014 which add to the effects of the treatment. The important thing is to synchronize the most demanding cognitive sessions with the on periods of treatment, and to communicate regularly with the neurologist about observed progress and difficulties.<\/pee>\n    <\/div>\n<div class=\"faq-item\">\n<h4>3. Are dual-task exercises dangerous for Parkinson&#8217;s patients?<\/h4>\n<pee>Improperly supervised, yes. Properly supervised, no \u2014 and they are even particularly beneficial as they directly address the dual-task deficit that characterizes Parkinson&#8217;s. The fundamental precautions: never perform motor-cognitive dual tasks standing or walking without physical support from a relative or physiotherapist, always on flat and clear ground, during on periods, with the possibility of immediate stopping. Pure cognitive dual tasks (counting + sorting cards while seated) are safe and very effective without these risks.<\/pee>\n    <\/div>\n<div class=\"faq-item\">\n<h4>4. How can I tell if my executive functions are deteriorating despite the exercises?<\/h4>\n<pee>Several practical indicators: daily activities that were easy become difficult (preparing a complex meal, managing one&#8217;s schedule), errors increase during usual exercises, or cognitive fatigue occurs earlier in the session. For an objective assessment, the DYNSEO executive functions test provides a non-medical indication. A complete neuropsychological assessment, conducted by a neuropsychologist every 12 to 18 months, is the clinical reference for tracking progress and adjusting the program.<\/pee>\n    <\/div>\n<div class=\"faq-item\">\n<h4>5. Can stimulating executive functions delay Lewy body dementia?<\/h4>\n<pee>No study currently proves that cognitive stimulation prevents or delays Lewy body dementia specifically. What it does \u2014 and this is clinically significant \u2014 is maintain a higher level of cognitive functioning for longer, by increasing cognitive reserve that compensates for progressive damage. Patients who maintain regular cognitive stimulation generally show better quality of life and preserved autonomy for longer, even though neuropathological progression is not stopped.<\/pee>\n    <\/div>\n<div class=\"faq-item\">\n<h4>6. Can these exercises be conducted by a non-professional relative?<\/h4>\n<pee>The vast majority of these exercises can be conducted by a trained relative \u2014 with the natural limits of non-professional competence. Motor dual-task exercises ideally require supervision from a physiotherapist. Other exercises (planning, flexibility, cognitive inhibition, working memory) are accessible to a motivated and informed relative. DYNSEO training for relatives provides a practical framework for conducting these exercises at home in a structured and safe manner. Regular validation by the neuropsychologist or speech therapist allows for level adjustment and detection of regressions.<\/pee>\n    <\/div>\n<div class=\"faq-item\">\n<h4>7. Is SCARLETT really usable by a Parkinson&#8217;s patient with tremors?<\/h4>\n<pee>SCARLETT was designed to be accessible to individuals with motor difficulties \u2014 the interface features large buttons, adjustable touch sensitivity, and vocal feedback for important elements. For patients with significant tremors, a suitable grip stylus (available at specialized pharmacies) can facilitate navigation. For severe fluctuations, it is recommended to use SCARLETT during on periods of treatment. An initial presentation by an occupational therapist is often helpful to optimize the personalized configuration of the interface.<\/pee>\n    <\/div>\n<div class=\"faq-item\">\n<h4>8. Does DYNSEO training for relatives cover the cognitive specifics of Parkinson&#8217;s?<\/h4>\n<pee>The training &#8220;Behavioral changes related to the disease \u2014 Practical guide for relatives&#8221; covers behavioral and cognitive changes related to chronic neurological diseases, including Parkinson&#8217;s disease. It provides guidelines on executive deficits and their daily manifestations, communication strategies adapted to on\/off fluctuations, and practical tools to support cognitive activities at home. It is Qualiopi certified (No. 11757351875), fundable via CPF for employees, and accessible online at one&#8217;s own pace from any device.<\/pee>\n    <\/div>\n<\/p><\/div>\n<\/section>\n<div class=\"container\">\n<div class=\"cta-block\">\n<h3>\ud83e\udde0 Preserve your autonomy with a personalized FE program<\/h3>\n<pee>Executive functions are the engine of daily autonomy in Parkinson&#8217;s disease. SCARLETT, CLINT, DYNSEO tools, and Qualiopi certified training accompany you in a structured program, adapted to on\/off fluctuations, and progressive to maintain quality of life for as long as possible.<\/pee>\n<div class=\"btns\">\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/scarlett-brain-games-for-seniors\/\" class=\"btn-white\">Discover SCARLETT \u2192<\/a><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/our-training-courses\/\" class=\"btn-outline\">Our training<\/a>\n  <\/div>\n<\/div>\n<\/div>\n<footer>\n  <pee>DYNSEO \u2014 Specialist in cognitive stimulation, neurodiversity, and professional training in health \u00b7 Paris 75015 \u00b7 Qualiopi No. 11757351875<\/pee>\n<div class=\"footer-links\">\n    <a href=\"https:\/\/www.dynseo.com\/en\/our-training-courses\/\">Our training<\/a><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/our-tools\/\">Our tools<\/a><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/our-tests\/\">Our tests<\/a><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/scarlett-brain-games-for-seniors\/\">SCARLETT<\/a><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/clint-brain-games-for-adults\/\">CLINT<\/a><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/\">dynseo.com<\/a>\n  <\/div>\n<\/footer>\n<\/div>\n<p>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":100456,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"[et_pb_section fb_built=\"1\" admin_label=\"Article HTML\" _builder_version=\"4.16\" custom_padding=\"0px||0px||false|false\" global_colors_info=\"{}\"][et_pb_row admin_label=\"Contenu\" _builder_version=\"4.16\" width=\"100%\" max_width=\"100%\" custom_padding=\"0px||0px||false|false\" global_colors_info=\"{}\"][et_pb_column type=\"4_4\" 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18px;box-shadow:var(--shc);border-top:3px solid var(--teal)}\n.dbi-art-a11be9 .fe-exo.pink-t {border-top-color:var(--pink)}\n.dbi-art-a11be9 .fe-exo.blue-t {border-top-color:var(--blue)}\n.dbi-art-a11be9 .fe-exo.yellow-t {border-top-color:#c49000}\n.dbi-art-a11be9 .fe-exo h5 {font-family:'Montserrat',sans-serif;font-size:13px;font-weight:700;color:var(--blue-dark);margin-bottom:8px}\n.dbi-art-a11be9 .fe-exo p {font-size:12px;color:var(--text-light);margin:0 0 8px;line-height:1.55}\n.dbi-art-a11be9 .fe-exo .fe-meta {display:flex;gap:6px;flex-wrap:wrap;margin-top:6px}\n.dbi-art-a11be9 .fe-badge {font-size:10px;font-weight:700;padding:2px 8px;border-radius:50px;background:var(--light-bg);color:var(--text-light)}\n.dbi-art-a11be9 .schedule-row {display:grid;grid-template-columns:140px 1fr 80px;gap:12px;padding:12px 16px;border-radius:8px;margin-bottom:8px;font-size:13px;align-items:center}\n.dbi-art-a11be9 .schedule-row:nth-child(odd) {background:var(--light-bg)}\n.dbi-art-a11be9 .schedule-row:nth-child(even) {background:#fff;box-shadow:var(--shc)}\n.dbi-art-a11be9 .schedule-row .sr-time {font-weight:700;color:var(--blue-dark)}\n.dbi-art-a11be9 .schedule-row .sr-label {font-size:11px;color:#1a6e50;font-weight:700;text-align:right}\n\n<\/style>\n<div class=\"dbi-art-a11be9\">\n<header class=\"hero\">\n  <div class=\"hero-tag\">\ud83e\udde0 Parkinson \u00b7 Executive functions \u00b7 Preservation program \u00b7 Neuropsychology<\/div>\n  <h1>Executive functions and Parkinson's: practical exercises to preserve them<\/h1>\n  <p class=\"hero-sub\">Parkinson's disease affects executive functions from early stages \u2014 planning, flexibility, inhibition, working memory, attention. This program of 20 targeted exercises, adapted to the specifics of Parkinson's, helps preserve them and maintain autonomy longer.<\/p>\n<\/header>\n\n<main class=\"container\">\n\n<div class=\"intro-box\"><p>Parkinson's disease is known for its motor symptoms \u2014 tremors, rigidity, bradykinesia. But beyond the motor picture, another neuropsychological terrain gradually erodes, often silently: <strong>executive functions<\/strong>. These high-level abilities \u2014 planning a sequence of actions, adapting when rules change, resisting an impulse, maintaining multiple pieces of information in mind simultaneously \u2014 are precisely those upon which daily autonomy depends. Preparing in the morning, managing medications, cooking a meal, managing one's schedule: all these activities mobilize executive functions. This guide offers a program of 20 practical exercises organized by executive function, specifically designed for the constraints of Parkinson's disease \u2014 adapted to on\/off fluctuations, accessible despite motor symptoms, and progressive to follow each patient's evolution.<\/p><\/div>\n\n<h2>1. Executive functions in Parkinson's disease<\/h2>\n\n<h3>1.1 Why Parkinson's specifically affects executive functions<\/h3>\n<p>Executive functions (EF) are primarily underpinned by the <strong>prefrontal cortex<\/strong> and its connections with the basal ganglia \u2014 the central gray nuclei at the heart of Parkinsonian pathology. Parkinson's disease causes dopaminergic depletion in the nigrostriatal circuits that govern not only motor control but also the frontostriatal loops involved in EF. From the early stages of the disease, even before motor disorders become disabling, subtle deficits in executive functions can be detected by sensitive neuropsychological tests.<\/p>\n<p>These Parkinsonian executive deficits have a characteristic profile: they primarily affect <strong>cognitive flexibility<\/strong> (difficulty in changing strategy or adapting to new rules), <strong>verbal fluency<\/strong> (notably generation fluency), <strong>planning<\/strong> (difficulty organizing complex action sequences), and <strong>working memory<\/strong> (reducing the ability to maintain and manipulate multiple pieces of information simultaneously). These deficits are distinct from those observed in Alzheimer's disease \u2014 where episodic memory is primarily affected \u2014 which explains why people with Parkinson's may have difficulty planning a trip while perfectly remembering their last birthday.<\/p>\n\n<div class=\"stats-grid\">\n  <div class=\"stat-card blue\">\n    <span class=\"stat-num\">50\u201370 %<\/span>\n    <span class=\"stat-label\">of Parkinson's patients exhibit measurable executive deficits from early stages (Aarsland et al., 2017)<\/span>\n  <\/div>\n  <div class=\"stat-card teal\">\n    <span class=\"stat-num\">3\u20135 years<\/span>\n    <span class=\"stat-label\">in advance: executive deficits often precede memory deficits in Parkinson's, unlike in Alzheimer's<\/span>\n  <\/div>\n  <div class=\"stat-card pink\">\n    <span class=\"stat-num\">+40 %<\/span>\n    <span class=\"stat-label\">improvement in EF among Parkinson's patients following a combined cognitive stimulation + physical activity program vs. control (Cruise et al., 2021)<\/span>\n  <\/div>\n  <div class=\"stat-card yellow\">\n    <span class=\"stat-num\">5 EFs<\/span>\n    <span class=\"stat-label\">primarily affected: planning, flexibility, inhibition, working memory, divided attention \u2014 specific program for each<\/span>\n  <\/div>\n<\/div>\n\n<h3>1.2 The clinical picture: how executive deficits manifest in daily life<\/h3>\n<p>Parkinsonian executive deficits do not always manifest obviously during ordinary conversation \u2014 which is why they are often underestimated by the patients themselves and by those around them. They become apparent during tasks that require complex organization, rapid adaptation, or simultaneous management of multiple pieces of information.<\/p>\n\n<table class=\"dynseo-table\">\n  <thead>\n    <tr>\n      <th>Executive function<\/th>\n      <th>Deficit in Parkinson's<\/th>\n      <th>Daily manifestation<\/th>\n      <th>Impact on autonomy<\/th>\n    <\/tr>\n  <\/thead>\n  <tbody>\n    <tr>\n      <td><strong>Planning<\/strong><\/td>\n      <td><span class=\"badge badge-pink\">Moderate to severe<\/span><\/td>\n      <td>Difficulty organizing a sequence of actions (recipe, route), forgetting steps<\/td>\n      <td>Cooking, managing medications, preparing outings<\/td>\n    <\/tr>\n    <tr>\n      <td><strong>Cognitive flexibility<\/strong><\/td>\n      <td><span class=\"badge badge-pink\">Affected early<\/span><\/td>\n      <td>Perseveration on a strategy even when it no longer works, difficulty changing topics or tasks<\/td>\n      <td>Adapting to unforeseen events, social conversations, driving<\/td>\n    <\/tr>\n    <tr>\n      <td><strong>Inhibition<\/strong><\/td>\n      <td><span class=\"badge badge-yellow\">Variable<\/span><\/td>\n      <td>Tendency to complete automatic movements (paradoxical freeze), impulsive responses, difficulty ignoring distractors<\/td>\n      <td>Safety at home, managing impulsive purchases, conversations<\/td>\n    <\/tr>\n    <tr>\n      <td><strong>Working memory<\/strong><\/td>\n      <td><span class=\"badge badge-pink\">Moderate<\/span><\/td>\n      <td>Loses track of a conversation, forgets what they were doing when moving from one room to another, difficulty doing two things at once<\/td>\n      <td>Dual tasking, managing the agenda, following conversations<\/td>\n    <\/tr>\n    <tr>\n      <td><strong>Divided attention<\/strong><\/td>\n      <td><span class=\"badge badge-pink\">Affected early<\/span><\/td>\n      <td>Marked difficulties sharing attention between two simultaneous tasks \u2014 particularly the dual task of walking + talking<\/td>\n      <td>Safety while walking, cooking, conversation during an activity<\/td>\n    <\/tr>\n  <\/tbody>\n<\/table>\n\n<h3>1.3 The dual task: a specific challenge of Parkinson's<\/h3>\n<p>One of the most specific and well-documented manifestations of executive deficits in Parkinson's is the difficulty with <strong>dual tasks<\/strong> \u2014 performing two activities simultaneously. A well-known phenomenon among clinicians is the deterioration of walking when the patient talks at the same time: the conversation absorbs attentional resources that should be available for the automatic regulation of walking, leading to slowing, instability, or even freezing. This is not ordinary distraction \u2014 it is a direct manifestation of the frontal executive deficit in managing limited attentional resources.<\/p>\n<p>This peculiarity has an important implication for the exercise program: stimulating EF in Parkinson's patients must include progressive dual task exercises, but always ensuring physical safety \u2014 never during fast walking or on uneven terrain in moderate or advanced stages.<\/p>\n\n<div class=\"teal-box\"><p>\ud83e\udde0 <strong>Parkinson's specificity:<\/strong> Unlike general cognitive stimulation programs, a specific program for Parkinson's must systematically take into account the on\/off windows of dopaminergic treatment. The most cognitively demanding exercises (flexibility, inhibition, dual task) should be planned during \"on\" phases \u2014 that is, 30 to 90 minutes after taking medication. Softer exercises (simple planning, autobiographical anchoring) can be practiced during periods of lower treatment effectiveness.<\/p><\/div>\n\n<h2>2. Program of 20 exercises by executive function<\/h2>\n\n<!-- EF 1: PLANNING -->\n<div class=\"fe-section\">\n<div class=\"fe-section-header\">\n    <div class=\"fe-icon\">\ud83d\uddfa\ufe0f<\/div>\n    <div>\n      <h3>FE 1 \u2014 Sequential Planning<\/h3>\n      <span>Organize a sequence of actions to achieve a goal \u00b7 Exercises 1\u20134<\/span>\n    <\/div>\n  <\/div>\n  <div class=\"fe-exo-grid\">\n    <div class=\"fe-exo\">\n      <h5>Planning the Day in Time Slots<\/h5>\n      <p>Every morning, plan the day by noting 4 to 6 activities with their estimated time and optimal order. At the end of the day, compare plan and realization: what was modified? Why? This meta-planning reflection strengthens the prefrontal circuits of planning while remaining close to real life.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Accessible<\/span><span class=\"fe-badge\">\ud83d\uddd3\ufe0f Functional<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo\">\n      <h5>Simplified Tower of Hanoi<\/h5>\n      <p>Version with 3 disks of the classic game (available in physical version or free app): move all disks from one peg to another while respecting the rule (never a large disk on a small one). Requires planning of at least 7 moves. Start with 3 disks, aim for 4. Excellent tree planning exercise.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 10 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\u265f\ufe0f Strategy<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo\">\n      <h5>Imaginary Route<\/h5>\n      <p>Choose a known route (going to the pharmacy, to the market) and plan it verbally out loud in the exact order: starting points, route, stops, order of purchases to optimize the journey, return. Then repeat with a less familiar route. Strengthens spatial and sequential planning.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83d\uddfa\ufe0f Visuo-spatial<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo\">\n      <h5>Mental Recipe<\/h5>\n      <p>Choose a familiar recipe and mentally reconstruct all the steps in the exact order \u2014 with the ingredients, durations, order of using the equipment. Then check with the actual recipe. Difficult variant: plan two simultaneous dishes while managing overlapping cooking times. Very close to the daily requirements of autonomy.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 10 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate to Challenging<\/span><span class=\"fe-badge\">\ud83c\udf73 Functional<\/span><\/div>\n    <\/div>\n  <\/div>\n<\/div>\n\n<!-- FE 2: FLEXIBILITY -->\n<div class=\"fe-section-header\">\n    <div class=\"fe-icon\">\ud83d\udd00<\/div>\n    <div>\n      <h3>FE 2 \u2014 Cognitive Flexibility<\/h3>\n      <span>Adapting when the rules change \u00b7 Exercises 5\u20138<\/span>\n    <\/div>\n  <\/div>\n  <div class=\"fe-exo-grid\">\n    <div class=\"fe-exo pink-t\">\n      <h5>Alternating Sorting Task (Simplified DCCS)<\/h5>\n      <p>Sort image cards by color for 2 minutes, then change the rule (sort by shape, or by the number of items) on signal. The exercise is difficult not because of the rules themselves, but because of the need to inhibit the previous rule. Repeat the alternation 4 to 6 times during the session.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 10 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83c\udccf Manipulative<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo pink-t\">\n      <h5>Alternating News Reading<\/h5>\n      <p>Read a newspaper article, then immediately give the opposite opinion orally to that expressed in the article. This perspective reversal exercise engages cognitive flexibility and theory of mind. Start with neutral topics (sports, culture), progress to more complex topics (politics, society).<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Stimulating<\/span><span class=\"fe-badge\">\ud83d\udcac Verbal<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo pink-t\">\n      <h5>Fluency by Alternating Categories<\/h5>\n      <p>Name alternately an animal, then a piece of furniture, then an animal, then a piece of furniture (etc.) for 3 minutes. The alternation constraint \u2014 changing category with each item \u2014 directly tests cognitive flexibility and verbal fluency, both affected in Parkinson's. Difficult variant: 3 categories in rotation.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 5 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83d\udde3\ufe0f Verbal<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo pink-t\">\n      <h5>Contextual Opposites Game<\/h5>\n      <p>Give the antonym of randomly presented words (fast\/slow, big\/small) \u2014 easy exercise. Then reverse: each time a word is presented, give a synonym EXCEPT for color words (give the antonym). This change of contextual rule mimics daily challenges of adapting to changing rules.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Stimulating<\/span><span class=\"fe-badge\">\ud83e\udde9 Cognitive<\/span><\/div>\n    <\/div>\n  <\/div>\n<\/div>\n\n<!-- FE 3: INHIBITION -->\n<div class=\"fe-section\">\n<div class=\"fe-section-header\">\n    <div class=\"fe-icon\">\ud83d\uded1<\/div>\n    <div>\n      <h3>FE 3 \u2014 Inhibition and response control<\/h3>\n      <span>Resist an automatic response \u00b7 Exercises 9\u201312<\/span>\n    <\/div>\n  <\/div>\n  <div class=\"fe-exo-grid\">\n    <div class=\"fe-exo blue-t\">\n      <h5>Simplified oral Stroop<\/h5>\n      <p>The adult presents color words written in a different ink (the word \"RED\" written in blue). The patient must name the color of the ink \u2014 not the written word. Resisting the impulse to read the word is the main difficulty. Start slowly, without time constraints, progressing to a faster pace.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 5 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83d\udc41\ufe0f Visual-verbal<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo blue-t\">\n      <h5>Vocal Stop-and-Go<\/h5>\n      <p>The patient recites the days of the week or the months. On signal (hand raised or noise), they stop immediately. On a second signal, they resume where they left off. Inhibiting a well-learned automatic sequence is particularly relevant in Parkinson's (freezing). Repeat 8 to 10 times during the session.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 5 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Easy<\/span><span class=\"fe-badge\">\ud83d\udde3\ufe0f Sequential<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo blue-t\">\n      <h5>Inverted Yes-No<\/h5>\n      <p>Ask questions to which the natural response would be \"yes\" \u2014 the patient must respond \"no\" and vice versa. \"Is it dark right now? (no) \u2192 respond yes.\" A simple and playful inhibition exercise, easily doable at home or in session. Progress to more complex questions.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 5 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Easy<\/span><span class=\"fe-badge\">\ud83d\udcac Playful<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo blue-t\">\n      <h5>Selective reading with inhibition criterion<\/h5>\n      <p>Read a short text while skipping all words from a defined category (e.g., skip all color words, or all animal names) without saying them aloud. Inhibiting specific words in a continuous reading flow is an advanced form of the inhibition exercise, closer to daily cognitive demands.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Challenging<\/span><span class=\"fe-badge\">\ud83d\udcda Reading<\/span><\/div>\n    <\/div>\n  <\/div>\n<\/div>\n\n<!-- FE 4: WORKING MEMORY -->\n<div class=\"fe-section\">\n<div class=\"fe-section-header\">\n    <div class=\"fe-icon\">\ud83d\udcbe<\/div>\n    <div>\n      <h3>FE 4 \u2014 Working Memory<\/h3>\n      <span>Maintain and manipulate short-term information \u00b7 Exercises 13\u201316<\/span>\n    <\/div>\n  <\/div>\n  <div class=\"fe-exo-grid\">\n    <div class=\"fe-exo yellow-t\">\n      <h5>Reverse Digit Span<\/h5>\n      <p>The caregiver or speech therapist states a series of digits (starting with 3) that the patient repeats in reverse. E.g.: \u201c4 \u2013 7 \u2013 2\u201d \u2192 respond \u201c2 \u2013 7 \u2013 4\u201d. Gradually increase the length of the series. This is the working memory exercise most directly correlated with daily life performance in Parkinson's patients.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 5 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83d\udd22 Verbal<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo yellow-t\">\n      <h5>Multi-step Message<\/h5>\n      <p>Memorize 3 to 4 actions to be performed in order in different rooms (e.g.: \u201c1. Place a book in the bedroom, 2. Turn off the hallway light, 3. Return by taking the longest route\u201d). Prospective and spatial working memory is one of the most functionally important in daily life for Parkinson's patients.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83c\udfc3 Functional<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo yellow-t\">\n      <h5>Series Mental Calculation<\/h5>\n      <p>Start at 100, subtract 7 each time: 100, 93, 86, 79... Maintaining the current result while calculating the next subtraction is a double demand on working memory. Adjust according to the level (subtract 3 for ease, subtract 7 for standard difficulty, 13 for a challenge).<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 5 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83d\udd22 Calculation<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo yellow-t\">\n      <h5>Delayed Reading Summary<\/h5>\n      <p>Read a short text (10 lines), set the text aside, wait 5 minutes (during which another activity is performed), then summarize the text from memory \u2014 main ideas, retained details, opinion. The voluntary interference between encoding and recall simulates the distractions of daily life that disrupt working memory in Parkinson's patients.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 12 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Stimulating<\/span><span class=\"fe-badge\">\ud83d\udcda Delayed Recall<\/span><\/div>\n    <\/div>\n  <\/div>\n<\/div>\n\n<!-- FE 5: DIVIDED ATTENTION -->\n<div class=\"fe-section\">\n<div class=\"fe-section-header\">\n    <div class=\"fe-icon\">\ud83c\udfaf<\/div>\n    <div>\n      <h3>FE 5 \u2014 Divided attention and secure dual task<\/h3>\n      <span>Share attention between two tasks \u00b7 Exercises 17\u201320 \u00b7 Safety first<\/span>\n    <\/div>\n  <\/div>\n  <p style=\"font-size:13px;color:var(--text-light);margin-bottom:16px\">\u26a0\ufe0f These exercises should never be performed while walking on uneven ground or in a fall-risk situation. Always seated or standing stable, on flat and clear ground for motor variants.<\/p>\n  <div class=\"fe-exo-grid\">\n    <div class=\"fe-exo\">\n      <h5>Seated dual task: counting + sorting<\/h5>\n      <p>Seated, sort colored cards with one hand while the other taps a steady rhythm on the table. Then switch hands. Next, sort the cards while counting aloud backwards from 20. This seated dual task is secure and directly targets central attentional sharing.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\u2705 Secure<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo\">\n      <h5>Rhythmic walking with counting (flat ground, accompanied)<\/h5>\n      <p>On flat, clear ground, accompanied by a relative or a physiotherapist: walk while counting aloud by 2s. Start with 30-second periods, gradually increasing. The goal is not speed but the simultaneous maintenance of walking AND counting. Stop as soon as the gait deteriorates.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 10 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Stimulating<\/span><span class=\"fe-badge\">\ud83d\udeb6 Accompanied<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo\">\n      <h5>Conversation during a simple manual task<\/h5>\n      <p>Perform a simple and automated manual task (folding laundry, sorting coins) while maintaining a normal conversation with a relative. Deliberately shift the main attention from the task to the conversation and vice versa. Exercise close to the most demanding daily situations in terms of divided attention.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 10 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83c\udfe0 Daily life<\/span><\/div>\n    <\/div>\n    <div class=\"fe-exo\">\n      <h5>Reading aloud + sensory monitoring<\/h5>\n      <p>Read a text aloud while being simultaneously attentive to the sounds of the environment \u2014 signal each time a particular sound (bird, car, clock) is heard. Exercise of auditory-visual divided attention that involves no motor risk and can be practiced independently.<\/p>\n      <div class=\"fe-meta\"><span class=\"fe-badge\">\u23f1 8 min<\/span><span class=\"fe-badge\">\ud83d\udcf6 Moderate<\/span><span class=\"fe-badge\">\ud83d\udd0a Sensory<\/span><\/div>\n    <\/div>\n  <\/div>\n<\/div>\n\n<h2>3. Adapt the program to Parkinson's fluctuations<\/h2>\n\n<h3>3.1 Understand and use on\/off windows<\/h3>\n<p>The vast majority of Parkinson's patients treated with levodopa experience fluctuations in treatment effectiveness throughout the day. \"On\" periods \u2014 when the treatment is effective \u2014 offer better mobility, greater energy, and optimized cognitive abilities. \"Off\" periods \u2014 at the end of treatment effectiveness \u2014 are accompanied by motor and cognitive slowing, increased fatigue, and sometimes dysphoria. Adapting the executive function stimulation program to this cycle is essential to maximize its effectiveness and to avoid counterproductive sessions conducted during periods of low cognitive availability.<\/p>\n\n<div class=\"process-track\">\n  <div class=\"process-step\">\n    <div class=\"ps-standard\">\n      <span class=\"ps-label\">\ud83d\udd34 OFF period or cognitive fatigue<\/span>\n      <h5>Not recommended exercises<\/h5>\n      <p>Dual task, Stroop, Tower of Hanoi, mental calculation in series \u2014 these demanding exercises during reduced effectiveness periods generate frustration, errors, and can discourage the continuation of the program.<\/p>\n    <\/div>\n    <div class=\"ps-adapted\">\n      <span class=\"ps-label\">\u2705 Exercises adapted to the OFF period<\/span>\n      <h5>Light and maintenance exercises<\/h5>\n      <p>Planning the day, simple mental recipe, gentle thematic conversation, emotional recognition exercises (Facial Expression Decoder). These activities maintain cognitive engagement without overloading.<\/p>\n    <\/div>\n  <\/div>\n  <div class=\"process-step\">\n    <div class=\"ps-standard\">\n      <span class=\"ps-label\">\ud83d\udfe2 Optimal ON period<\/span>\n      <h5>Ideal window for demanding exercises<\/h5>\n      <p>30 to 90 minutes after taking the treatment: this is the ideal time for flexibility, inhibition, dual task, and intensive working memory exercises. Plan the most ambitious sessions at these times.<\/p>\n    <\/div>\n    <div class=\"ps-adapted\">\n      <span class=\"ps-label\">\u2705 Recommended sequence during ON period<\/span>\n      <h5>Complete program of 25-30 minutes<\/h5>\n      <p>5 min heart coherence (activation) \u2192 8 min demanding EF exercise (flexibility or inhibition) \u2192 8 min moderate EF exercise (working memory) \u2192 5 min gentle exercise (planning or emotional recognition) \u2192 assessment.<\/p>\n    <\/div>\n  <\/div>\n<\/div>\n\n<h3>3.2 The role of the Facial Expression Decoder in Parkinson's<\/h3>\n<p>A often overlooked deficit in Parkinson's disease is the difficulty in recognizing and interpreting the emotional expressions of others \u2014 a disorder related to hypomimia (reduction of the patient's own facial expressions) and changes in amygdaloid and striatal circuits. This social cognition deficit has direct consequences on daily interactions: the patient may miss important emotional signals in a conversation, leading to misunderstandings and gradual social withdrawal.<\/p>\n<p>Daily exercise with the <a href=\"https:\/\/www.dynseo.com\/nos-outils\/decodeur-dexpressions-faciales\/\">DYNSEO Facial Expression Decoder<\/a> \u2014 identifying and naming emotions on photographed faces \u2014 is a direct and targeted training of this ability. It can be integrated into the EF stimulation program as an exercise of social attention and recognition of non-verbal cues, particularly suited for periods of cognitive fatigue as it does not require complex verbal production.<\/p>\n\n<h2>3 bis. Integrate EF into daily activities<\/h2>\n\n<h3>Ordinary activities as a continuous stimulation ground<\/h3>\n<p>Beyond structured exercise sessions, daily life itself offers permanent opportunities for executive function stimulation \u2014 provided they are approached deliberately and consciously. For Parkinson's patients, whose windows of cognitive availability are limited, maximizing the impact of each ordinary activity is as important a strategy as formal exercises.<\/p>\n<p>The <strong>meal preparation<\/strong> is one of the richest domestic activities in terms of executive stimulation: planning (defining the order of preparations), flexibility (adapting if an ingredient is missing), working memory (remembering the steps completed and upcoming), inhibition (resisting tasting before finishing), and divided attention (monitoring cooking while preparing something else). Encouraging the patient to prepare their own meal for as long as possible \u2014 with safety adaptations if necessary \u2014 is an invaluable daily executive exercise.<\/p>\n<p>The <strong>medication management<\/strong> is another central executive activity for Parkinson's patients: noting their doses, planning times according to meals, anticipating restocking, adapting if a pill has been forgotten. Using a weekly pill organizer, a displayed tracking chart, or a reminder app is not a capitulation to the disease \u2014 it is an executive compensation strategy that frees cognitive resources for other more stimulating activities.<\/p>\n<p>The <a href=\"https:\/\/www.dynseo.com\/nos-outils\/roue-des-choix\/\">DYNSEO Wheel of Choices<\/a> makes perfect sense here: faced with Parkinsonian apathy that can paralyze initiative (\u201cI don\u2019t know what to do, so I do nothing\u201d), the wheel of choices visually offers options for cognitively stimulating activities \u2014 gardening, reading, calling a friend, preparing a recipe. Each small act of decision and initiation exercises the prefrontal circuits against apathy, gradually preserving decision-making autonomy.<\/p>\n\n<h2>4. DYNSEO tools to support the program<\/h2>\n\n<div class=\"formation-block\">\n  <div class=\"fb-body\">\n    <div class=\"fb-tag\">\ud83c\udf93 Certified training \u00b7 Qualiopi No. 11757351875<\/div>\n    <h3>Behavioral changes related to the disease \u2014 Practical guide for relatives<\/h3>\n    <p>Daily support for a person with Parkinson's requires understanding not only motor symptoms but also cognitive and behavioral changes related to executive deficits. This Qualiopi certified training provides family caregivers with neurobiological markers, adapted communication strategies, and tools to maintain their own balance in this demanding role.<\/p>\n    <div class=\"fb-meta\">\n      <span>\ud83d\udc68\u200d\ud83d\udc69\u200d\ud83d\udc67 Families and caregivers of Parkinson's patients<\/span>\n      <span>\ud83d\udcbb 100% online, at your own pace<\/span>\n      <span>\ud83c\udfc6 Qualiopi certified<\/span>\n      <span>\ud83e\udde0 Accessible neurological approach<\/span>\n    <\/div>\n    <a href=\"https:\/\/www.dynseo.com\/courses\/changements-de-comportement-lies-a-maladie-guide-pratique-pour-les-proches\" class=\"btn-primary\">Discover the training \u2192<\/a>\n  <\/div>\n<\/div>\n\n<h3>DYNSEO practical tools<\/h3>\n<div class=\"tools-grid\">\n  <div class=\"tool-card\">\n    <h5>\ud83c\udf21\ufe0f Emotion thermometer<\/h5>\n    <p>Assess emotional state and cognitive fatigue before each session \u2014 essential for choosing the appropriate exercise level according to the day's on\/off windows.<\/p>\n    <a href=\"https:\/\/www.dynseo.com\/nos-outils\/thermometre-des-emotions\/\">Download \u2192<\/a>\n  <\/div>\n  <div class=\"tool-card\">\n    <h5>\ud83c\udfa1 Wheel of choices<\/h5>\n    <p>Support decision-making autonomy weakened by Parkinsonian apathy \u2014 choosing the exercise of the day from available options maintains personal initiative and engagement in the program.<\/p>\n    <a href=\"https:\/\/www.dynseo.com\/nos-outils\/roue-des-choix\/\">Download \u2192<\/a>\n  <\/div>\n  <div class=\"tool-card\">\n    <h5>\ud83d\ude0a Facial Expression Decoder<\/h5>\n    <p>Exercise 18 of the program \u2014 trains the recognition of emotions on faces, a capacity diminished in Parkinson's with real social consequences. Accessible even during periods of cognitive fatigue.<\/p>\n    <a href=\"https:\/\/www.dynseo.com\/nos-outils\/decodeur-dexpressions-faciales\/\">Download \u2192<\/a>\n  <\/div>\n  <div class=\"tool-card\">\n    <h5>\ud83d\udd0a Complex sounds pictogram<\/h5>\n    <p>Progressive cognitive auditory training \u2014 stimulates sound recognition and auditory attention, important complements to the specific divided attention program for Parkinson's.<\/p>\n    <a href=\"https:\/\/www.dynseo.com\/nos-outils\/imagier-des-sons-complexes\/\">Download \u2192<\/a>\n  <\/div>\n  <div class=\"tool-card\">\n    <h5>\ud83d\udde3\ufe0f Articulation tracking chart<\/h5>\n    <p>Dysarthria (speech disorders) is common in Parkinson's and affects communication during verbal exercises. This chart allows tracking of articulation progress and coordination with the speech therapist.<\/p>\n    <a href=\"https:\/\/www.dynseo.com\/nos-outils\/tableau-de-suivi-articulatoire\/\">Download \u2192<\/a>\n  <\/div>\n<\/div>\n\n<p>\u2192 <a href=\"https:\/\/www.dynseo.com\/nos-outils\/\">See all DYNSEO tools<\/a><\/p>\n\n<h3>DYNSEO applications for cognitive stimulation<\/h3>\n<div class=\"appli-grid\">\n  <div class=\"appli-card\">\n    <h5>\ud83d\udc74 SCARLETT \u2014 Seniors &amp; Parkinson<\/h5>\n    <p>Cognitive stimulation application for seniors designed with a touch interface adapted to Parkinsonian motor difficulties. Personalized pathways for EF and memory. Usable independently or with support.<\/p>\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/scarlett-brain-games-for-seniors\/\">Learn more \u2192<\/a>\n  <\/div>\n  <div class=\"appli-card\">\n    <h5>\ud83e\udde0 CLINT \u2014 Adults<\/h5>\n    <p>Cognitive remediation pathways for adults \u2014 adaptive exercises on memory, attention, and reasoning. Ideal for early and intermediate stage Parkinson's patients, as a complement to the EF program.<\/p>\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/clint-brain-games-for-adults\/\">Learn more \u2192<\/a>\n  <\/div>\n  <div class=\"appli-card\">\n    <h5>\ud83d\udcac MY DICTIONARY \u2014 Communication<\/h5>\n    <p>For Parkinson's patients developing severe verbal expression difficulties (advanced dysarthria, Parkinsonian aphasia) \u2014 maintain communication despite language disorders.<\/p>\n    <a href=\"https:\/\/www.dynseo.com\/mon-dico-une-application-pour-favoriser-la-communication\/\">Learn more \u2192<\/a>\n  <\/div>\n  <div class=\"appli-card\">\n    <h5>\ud83e\udd16 DYNSEO AI Coach<\/h5>\n    <p>Personalized support to guide patients and relatives in choosing exercises adapted to the on\/off windows, disease stage, and identified specific deficits.<\/p>\n    <a href=\"https:\/\/www.dynseo.com\/coach-ia\/\">Learn more \u2192<\/a>\n  <\/div>\n<\/div>\n\n<h3>DYNSEO cognitive tests<\/h3>\n<div class=\"formations-links\">\n  <div class=\"formation-link\">\n    <span>Non-medical test \u00b7 Online assessment<\/span>\n    <a href=\"https:\/\/www.dynseo.com\/test-memoire\/\">DYNSEO memory test<\/a>\n  <\/div>\n  <div class=\"formation-link\">\n    <span>Non-medical test \u00b7 Online assessment<\/span>\n    <a href=\"https:\/\/www.dynseo.com\/test-concentration-attention\/\">Concentration and attention test<\/a>\n  <\/div>\n  <div class=\"formation-link\">\n    <span>Non-medical test \u00b7 Online assessment<\/span>\n    <a href=\"https:\/\/www.dynseo.com\/test-des-fonctions-executives\/\">Executive functions test<\/a>\n  <\/div>\n<\/div>\n<p>\u2192 <a href=\"https:\/\/www.dynseo.com\/nos-tests\/\">Access all DYNSEO cognitive tests<\/a><\/p>\n\n<h3>DYNSEO training<\/h3>\n<div class=\"formations-links\">\n  <div class=\"formation-link\">\n    <span>For families and caregivers of Parkinson's patients<\/span>\n    <a href=\"https:\/\/www.dynseo.com\/courses\/changements-de-comportement-lies-a-maladie-guide-pratique-pour-les-proches\">Behavioral changes \u2014 Practical guide for relatives<\/a>\n  <\/div>\n  <div class=\"formation-link\">\n    <span>For health and care professionals<\/span>\n    <a href=\"https:\/\/www.dynseo.com\/courses\/troubles-du-comportement-lies-a-la-maladie-methodes-et-coordination-pluridisciplinaire\">Behavioral disorders \u2014 Methods and multidisciplinary coordination<\/a>\n  <\/div>\n<\/div>\n<p>\u2192 <a href=\"https:\/\/www.dynseo.com\/nos-formations\/\">See the complete DYNSEO training catalog<\/a><\/p>\n\n<div class=\"cta-block\">\n  <h3>\ud83e\udde0 Preserve your executive functions with DYNSEO<\/h3>\n  <p>SCARLETT and CLINT for daily stimulation, the 5 practical DYNSEO tools (Thermometer, Wheel of choices, Decoder, Pictogram, Articulation chart) and the Qualiopi certified training for relatives \u2014 a complete program to maintain autonomy and quality of life in Parkinson's disease.<\/p>\n  <div class=\"btns\">\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/scarlett-brain-games-for-seniors\/\" class=\"btn-white\">Discover SCARLETT \u2192<\/a>\n    <a href=\"https:\/\/www.dynseo.com\/test-des-fonctions-executives\/\" class=\"btn-outline\">Test my EF<\/a>\n  <\/div>\n<\/div>\n\n<\/main>\n<section class=\"faq-section\">\n  <div class=\"container\">\n    <h2>\u2753 FAQ \u2014 Executive functions and Parkinson's disease<\/h2>\n\n    <div class=\"faq-item\">\n      <h4>1. What is the difference between memory deficits in Parkinson's and those in Alzheimer's?<\/h4>\n      <p>The difference is fundamental and clinically important. In Alzheimer's disease, it is recent episodic memory that is affected first \u2014 the person forgets recent events irreversibly. In Parkinson's disease, it is first working memory and executive functions that are affected \u2014 the person has difficulty organizing and planning, but can often remember recent facts if provided with retrieval cues. The neuropsychological profile is distinct enough to require different assessments and stimulation programs, even though both can coexist in advanced stages.<\/p>\n    <\/div>\n\n    <div class=\"faq-item\">\n      <h4>2. Are these exercises compatible with levodopa treatment?<\/h4>\n      <p>Yes \u2014 and they are more effective in combination with optimized treatment. Dopaminergic treatment improves executive functions by partially restoring fronto-striatal circuits. Complementary cognitive stimulation acts on other mechanisms \u2014 neuroplasticity, strengthening of alternative circuits, improvement of cognitive reserve \u2014 which add to the effects of the treatment. The important thing is to synchronize the most demanding cognitive sessions with the on periods of treatment, and to communicate regularly with the neurologist about observed progress and difficulties.<\/p>\n    <\/div>\n\n    <div class=\"faq-item\">\n      <h4>3. Are dual-task exercises dangerous for Parkinson's patients?<\/h4>\n      <p>Improperly supervised, yes. Properly supervised, no \u2014 and they are even particularly beneficial as they directly address the dual-task deficit that characterizes Parkinson's. The fundamental precautions: never perform motor-cognitive dual tasks standing or walking without physical support from a relative or physiotherapist, always on flat and clear ground, during on periods, with the possibility of immediate stopping. Pure cognitive dual tasks (counting + sorting cards while seated) are safe and very effective without these risks.<\/p>\n    <\/div>\n\n    <div class=\"faq-item\">\n      <h4>4. How can I tell if my executive functions are deteriorating despite the exercises?<\/h4>\n      <p>Several practical indicators: daily activities that were easy become difficult (preparing a complex meal, managing one's schedule), errors increase during usual exercises, or cognitive fatigue occurs earlier in the session. For an objective assessment, the DYNSEO executive functions test provides a non-medical indication. A complete neuropsychological assessment, conducted by a neuropsychologist every 12 to 18 months, is the clinical reference for tracking progress and adjusting the program.<\/p>\n    <\/div>\n\n    <div class=\"faq-item\">\n      <h4>5. Can stimulating executive functions delay Lewy body dementia?<\/h4>\n      <p>No study currently proves that cognitive stimulation prevents or delays Lewy body dementia specifically. What it does \u2014 and this is clinically significant \u2014 is maintain a higher level of cognitive functioning for longer, by increasing cognitive reserve that compensates for progressive damage. Patients who maintain regular cognitive stimulation generally show better quality of life and preserved autonomy for longer, even though neuropathological progression is not stopped.<\/p>\n    <\/div>\n\n    <div class=\"faq-item\">\n      <h4>6. Can these exercises be conducted by a non-professional relative?<\/h4>\n      <p>The vast majority of these exercises can be conducted by a trained relative \u2014 with the natural limits of non-professional competence. Motor dual-task exercises ideally require supervision from a physiotherapist. Other exercises (planning, flexibility, cognitive inhibition, working memory) are accessible to a motivated and informed relative. DYNSEO training for relatives provides a practical framework for conducting these exercises at home in a structured and safe manner. Regular validation by the neuropsychologist or speech therapist allows for level adjustment and detection of regressions.<\/p>\n    <\/div>\n\n    <div class=\"faq-item\">\n      <h4>7. Is SCARLETT really usable by a Parkinson's patient with tremors?<\/h4>\n      <p>SCARLETT was designed to be accessible to individuals with motor difficulties \u2014 the interface features large buttons, adjustable touch sensitivity, and vocal feedback for important elements. For patients with significant tremors, a suitable grip stylus (available at specialized pharmacies) can facilitate navigation. For severe fluctuations, it is recommended to use SCARLETT during on periods of treatment. An initial presentation by an occupational therapist is often helpful to optimize the personalized configuration of the interface.<\/p>\n    <\/div>\n\n    <div class=\"faq-item\">\n      <h4>8. Does DYNSEO training for relatives cover the cognitive specifics of Parkinson's?<\/h4>\n      <p>The training \"Behavioral changes related to the disease \u2014 Practical guide for relatives\" covers behavioral and cognitive changes related to chronic neurological diseases, including Parkinson's disease. It provides guidelines on executive deficits and their daily manifestations, communication strategies adapted to on\/off fluctuations, and practical tools to support cognitive activities at home. It is Qualiopi certified (No. 11757351875), fundable via CPF for employees, and accessible online at one's own pace from any device.<\/p>\n    <\/div>\n  <\/div>\n<\/section>\n<div class=\"container\">\n<div class=\"cta-block\">\n  <h3>\ud83e\udde0 Preserve your autonomy with a personalized FE program<\/h3>\n  <p>Executive functions are the engine of daily autonomy in Parkinson's disease. SCARLETT, CLINT, DYNSEO tools, and Qualiopi certified training accompany you in a structured program, adapted to on\/off fluctuations, and progressive to maintain quality of life for as long as possible.<\/p>\n  <div class=\"btns\">\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/scarlett-brain-games-for-seniors\/\" class=\"btn-white\">Discover SCARLETT \u2192<\/a>\n    <a href=\"https:\/\/www.dynseo.com\/nos-formations\/\" class=\"btn-outline\">Our training<\/a>\n  <\/div>\n<\/div>\n<\/div>\n\n<footer>\n  <p>DYNSEO \u2014 Specialist in cognitive stimulation, neurodiversity, and professional training in health \u00b7 Paris 75015 \u00b7 Qualiopi No. 11757351875<\/p>\n  <div class=\"footer-links\">\n    <a href=\"https:\/\/www.dynseo.com\/nos-formations\/\">Our training<\/a>\n    <a href=\"https:\/\/www.dynseo.com\/nos-outils\/\">Our tools<\/a>\n    <a href=\"https:\/\/www.dynseo.com\/nos-tests\/\">Our tests<\/a>\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/scarlett-brain-games-for-seniors\/\">SCARLETT<\/a>\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/clint-brain-games-for-adults\/\">CLINT<\/a>\n    <a href=\"https:\/\/www.dynseo.com\/\">dynseo.com<\/a>\n  <\/div>\n<\/footer>\n<\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]","_et_gb_content_width":"","footnotes":""},"categories":[2915],"tags":[],"class_list":["post-748398","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-les-conseils-des-coachs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Executive Functions and Parkinson&#039;s: Practical Exercises to Preserve Them - DYNSEO - Educational apps &amp; 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