Effects of Distinct Dual-tasks on Gait and the Correlation between Gait speed and Clinical Features in Parkinson’s disease

Abstract

Background Gait impairment is a common and disabling motor symptom in Parkinson’s disease (PD), deteriorated gait parameters have showed in both single-task (ST) and dual-task (DT) conditions. The aim of this study was to investigate the effects of different motor-cognitive and motor-motor DTs on gait and the correlation between gait speed and clinical features in PD patients. Methods Fifty-six individuals with PD completed two motor-cognitive DTs (serial-7 subtractionand digit backward) and one motor-motor DT (button pressing). Spatiotemporal gait parameters were evaluated by wearable sensors. DT effects (DTEs) of gait parameters were calculated. Clinical variables recorded including Hoehn & Yahr (H-Y) staging, Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part I, II and III, New Freezing of Gait Questionnaire (NFOG-Q), Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), 39-item Parkinson’s Disease Questionnaire (PDQ-39) and Nonmotor Symptom Scale (NMSS). Results Gait parameters including gait speed, cadence, stride length, gait cycle duration, double support phase deteriorated under the motor-cognitive DT conditions by Paired-sample t test and Wilcoxon signed-rank test (p＜0.01, p＜0.05). The motor-motor DT had no significant effect on gait performance except for gait speed (p＞0.05). The serial-7 subtraction DT paradigm had similar effect on gait with the digit backward DT. Gait speed was negatively correlated with MDS-UPDRS I, II, HAMA, HAMD, NMSS and PDQ-39 scores in PD patients under both ST and DT conditions (p＜0.01, p＜0.05). Conclusion Effects of DT conditions on gait deficits were independent of the types of cognitive tasks. Gait speed was influenced by clinical features of PD under both ST and DT conditions. Whatever the types, motor-cognitive DT training should be used to improve gait performance under DT conditions, which is required to provide more therapeutic support of PD patients in the future.