Dual-task Interference Disrupts Parkinson’s Gait Across Multiple Cognitive Domains

Penko, Amanda L.; Streicher, Matthew C.; Koop, Mandy Miller; Dey, Tanujit; Rosenfeldt, Anson B.; Bazyk, Andrew; Alberts, Jay L.

doi:10.1016/j.neuroscience.2018.03.021

Cited by 39 publications

(21 citation statements)

References 42 publications

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“…The PD non-MCI group instead prioritized gait speed over cognition, whereas they did not prioritize one task over the other with respect to cognition and step time variability. The general finding of DT costs within 4 out of 5 domains of gait is supported by other studies reporting impaired performance during dual tasking within the pace, 14,16,[44][45][46][47][48][49][50][51] rhythm, 14,47,48,50,51 variability, 14,45,48,49 and postural control domains. 48 In the current study, DT costs in the variability domains were not only significant across all variables, but these costs were also the highest compared to the other domains.…”

Section: Discussionsupporting

confidence: 70%

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Dual-Task Effects During a Motor-Cognitive Task in Parkinson’s Disease: Patterns of Prioritization and the Influence of Cognitive Status

Johansson

Ekman

Rennie

et al. 2021

Neurorehabil Neural Repair

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People with Parkinson’s disease (PD) experience greater difficulties during dual task (DT) walking compared to healthy controls, but factors explaining the variance in DT costs remain largely unknown. Additionally, as cognitive impairments are common in PD it is important to understand whether cognitive status influences the strategies used during DT paradigms. The study aimed to (1) explore DT costs on gait and cognition during DT walking, (2) investigate factors associated with DT costs, and (3) to investigate to what extent patterns of DT costs and prioritization differed according to cognitive status. A total of 93 people with Parkinson’s disease were examined when walking in single and DT conditions. Information regarding demographics, PD severity, mobility, and cognitive and affective symptoms was collected, and an extensive neuropsychological test battery was used to classify whether participants had mild cognitive impairment (PD MCI) or not (PD non-MCI). Dual task costs were observed across all gait domains except asymmetry. Cognitive status was associated with DT costs on both gait and cognition. Nonmotor experiences of daily living were further associated with DT cost on cognition, and TUG-cog associated with DT cost on gait. People with PD MCI had larger DT costs on gait than PD non-MCI. Strategies differed according to cognitive status, whereby PD MCI used a posture-second strategy, and PD non-MCI used a posture-first strategy. Once verified in future studies, these results can inform clinicians and researchers when tailoring DT training paradigms to the specific characteristics of people with PD.

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Section: Discussionsupporting

confidence: 70%

“…Cutoffs used for each score were the following: 1 = ≤1 standard deviation (SD), 2 = 1.01 to 1. 49 Dual Task Gait Assessment. An electronic walkway system (GAITRite, active zone: 8.3 m, CIR Systems, Inc) was used to measure temporal and spatial gait parameters during single and DT conditions.…”

Section: Procedures and Outcomesmentioning

confidence: 99%

Dual-Task Effects During a Motor-Cognitive Task in Parkinson’s Disease: Patterns of Prioritization and the Influence of Cognitive Status

Johansson

Ekman

Rennie

et al. 2021

Neurorehabil Neural Repair

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“…The additional cognitive demands of the dual-task condition had a larger effect on PD patients in comparison to healthy subjects, which is also consistent with previous reports [ 53 , 54 ]. The observed enhancement of gait disturbances during the dual-task condition has been explained as a consequence of the activation of parallel processes in frontal attentional areas, which interferes with basal gait commands [ 55 ]. Such interference could be less pronounced during the early stages of PD when cognition is generally well-enough preserved to over-compensate for this attentional interference [ 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

Validity and sensitivity of instrumented postural and gait assessment using low-cost devices in Parkinson’s disease

Álvarez

Latorre

Aguilar

et al. 2020

J NeuroEngineering Rehabil

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Background Accurate assessment of balance and gait is necessary to monitor the clinical progress of Parkinson’s disease (PD). Conventional clinical scales can be biased and have limited accuracy. Novel interactive devices are potentially useful to detect subtle posture or gait-related impairments. Methods Posturographic and single and dual-task gait assessments were performed to 54 individuals with PD and 43 healthy controls with the Wii Balance Board and the Kinect v2 and the, respectively. Individuals with PD were also assessed with the Tinetti Performance Oriented Mobility Assessment, the Functional Gait Assessment and the 10-m Walking Test. The influence of demographic and clinical variables on the performance in the instrumented posturographic and gait tests, the sensitivity of these tests to the clinical condition and phenotypes, and their convergent validity with clinical scales were investigated. Results Individuals with PD in H&Y I and I.5 stages showed similar performance to controls. The greatest differences in posture and gait were found between subjects in H&Y II.5 and H&Y I–I.5 stage, as well as controls. Dual-tasking enhanced the differences among all groups in gait parameters. Akinetic/rigid phenotype showed worse postural control and gait than other phenotypes. High significant correlations were found between the limits of stability and most of gait parameters with the clinical scales. Conclusions Low-cost devices showed potential to objectively quantify posture and gait in established PD (H&Y ≥ II). Dual-tasking gait evaluation was more sensitive to detect differences among PD stages and compared to controls than free gait. Gait and posture were more impaired in akinetic/rigid PD.

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“…For example, in order to improve stepping amplitude symmetry, sensorimotor contingencies can be manipulated in VR so that people with PD step to a target that is visually perceived to be of a smaller range of motion than is actually achieved thereby training their motor systems to produce larger movements during subsequent trials 42 . Moreover, objective behavioural outcomes, physiological measures, as well as mobile neuroimaging can all be collected in a highly controlled and safe laboratory setting while participants feel as if they are ambulating in real-life scenarios 16,43 . Second, VR can simulate situations that would be too dangerous or cumbersome to perform in a clinical setting.…”

Section: [H1] Vr For Exploring Underlying Mechanisms [H2] Rationalementioning

confidence: 99%

“…Non-immersive VR via visual augmentation has been applied to study gait and balance while people with PD stand on a platform, walk on a treadmill or walk overground. Systems with embedded motion capture are usually confined to research settings 43,55,66,67 ; however, other systems can be more easily translated to the clinic. For example, participants with and without FOG were studied while stepping in place on a balance platform in order to navigate through narrow and wide virtual corridors (which often trigger FOG in real life) 68 .…”

Section: [H3] Non-immersive Vr Via Visual Augmentationmentioning

confidence: 99%

Virtual reality in research and rehabilitation of gait and balance in Parkinson disease

et al. 2020

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Virtual reality (VR) technology has emerged as a promising tool for studying and rehabilitating gait and balance impairments in people with Parkinson disease (PD) as it allows users to be engaged in an enriched and highly individualized complex environment. This Review examines the rationale and evidence for using VR in the assessment and rehabilitation of people with PD, makes recommendations for future research and discusses the use of VR in the clinic. In the assessment of people with PD, VR has been used to manipulate environments to enhance study of the behavioural and neural underpinnings of gait and balance, improving understanding of the motor-cognitive neural circuitry involved. Despite suggestions that VR can provide rehabilitation that is more effective and less labour intensive than non-VR rehabilitation, little evidence exists to date to support these claims. Nevertheless, much unrealised potential exists for the use of VR to provide personalized assessment and rehabilitation that optimises motor learning both in the clinic and home environments, and adapts to change in individuals over time. Design of such systems will require collaboration between all stakeholders to maximise useability, engagement, safety and effectiveness. [H1] INTRODUCTIONParkinson disease (PD) is a complex, progressive multi-system neurodegenerative disorder associated with motor and non-motor impairments 1 . The hallmark motor symptoms include bradykinesia, rigidity, tremor and postural instability,

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Dual-task Interference Disrupts Parkinson’s Gait Across Multiple Cognitive Domains

Cited by 39 publications

References 42 publications

Dual-Task Effects During a Motor-Cognitive Task in Parkinson’s Disease: Patterns of Prioritization and the Influence of Cognitive Status

Dual-Task Effects During a Motor-Cognitive Task in Parkinson’s Disease: Patterns of Prioritization and the Influence of Cognitive Status

Validity and sensitivity of instrumented postural and gait assessment using low-cost devices in Parkinson’s disease

Virtual reality in research and rehabilitation of gait and balance in Parkinson disease

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