The effect of directing attention during walking under dual-task conditions in Parkinson's disease

2005 ◽  
Vol 11 (2) ◽  
pp. 95-99 ◽  
Author(s):  
Colleen G. Canning
Author(s):  
Samira Ahmadi ◽  
Tarique Siragy ◽  
Julie Nantel

Abstract Background Regularity, quantified by sample entropy (SampEn), has been extensively used as a gait stability measure. Yet, there is no consensus on the calculation process and variant approaches, e.g. single-scale SampEn with and without incorporating a time delay greater than one, multiscale SampEn, and complexity index, have been used to calculate the regularity of kinematic or kinetic signals. The aim of the present study was to test the discriminatory performance of the abovementioned approaches during single and dual-task walking in people with Parkinson’s disease (PD). Methods Seventeen individuals with PD were included in this study. Participants completed two walking trials that included single and dual-task conditions. The secondary task was word searching with twelve words randomly appearing in the participants’ visual field. Trunk linear acceleration at sternum level, linear acceleration of the center of gravity, and angular velocity of feet, shanks, and thighs, each in three planes of motion were collected. The regularity of signals was computed using approaches mentioned above for single and dual-task conditions. Results Incorporating a time delay greater than one and considering multiple scales helped better distinguish between single and dual-task walking. For all signals, the complexity index, defined as the summary of multiscale SampEn analysis, was the most efficient discriminatory index between single-task walking and dual-tasking in people with Parkinson's disease. Specifically, the complexity index of the trunk linear acceleration of the center of gravity distinguished between the two walking conditions in all three planes of motion. Conclusions The significant results observed across the 24 signals studied in this study are illustrative examples of the complexity index’s potential as a gait feature for classifying different walking conditions.


2019 ◽  
Vol 27 (6) ◽  
pp. 843-847 ◽  
Author(s):  
Anson B. Rosenfeldt ◽  
Amanda L. Penko ◽  
Andrew S. Bazyk ◽  
Matthew C. Streicher ◽  
Tanujit Dey ◽  
...  

The aim of this project was to (a) evaluate the potential of the 2-min walk test to detect declines in gait velocity under dual-task conditions and (b) compare gait velocity overground and on a self-paced treadmill in Parkinson’s disease (PD). In total, 23 individuals with PD completed the 2-min walk test under single- and dual-task (serial 7s) conditions overground and on a self-paced treadmill. There was a significant decrease in gait velocity from single- to dual-task conditions overground (1.32 ± 0.22 to 1.10 ± 0.25 m/s; p < .001) and on the self-paced treadmill (1.24 ± 0.21 to 1.05 ± 0.25 m/s; p < .001). Overground and treadmill velocities were not statistically different from each other; however, differences approached or exceeded the minimal clinical important difference. The 2-min walk test coupled with a cognitive task provides an effective model of identifying dual-task declines in individuals with PD. Further studies comparing overground and self-paced treadmill velocity is warranted in PD.


2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Valerie E. Kelly ◽  
Alexis J. Eusterbrock ◽  
Anne Shumway-Cook

Gait impairments in Parkinson's disease (PD) are exacerbated under dual-task conditions requiring the simultaneous performance of cognitive or motor tasks. Dual-task walking deficits impact functional mobility, which often requires walking while performing concurrent tasks such as talking or carrying an object. The consequences of gait impairments in PD are significant and include increased disability, increased fall risk, and reduced quality of life. However, effective therapeutic interventions for dual-task walking deficits are limited. The goals of this narrative review are to describe dual-task walking deficits in people with PD, to discuss motor and cognitive factors that may contribute to these deficits, to review potential mechanisms underlying dual-task deficits, and to discuss the effect of therapeutic interventions on dual-task walking deficits in persons with PD.


2015 ◽  
Vol 42 (3) ◽  
pp. 323-328 ◽  
Author(s):  
Ângela Fernandes ◽  
Tiago Coelho ◽  
Ana Vitória ◽  
Augusto Ferreira ◽  
Rubim Santos ◽  
...  

2018 ◽  
Vol 48 ◽  
pp. 61-67 ◽  
Author(s):  
Elise I. Baron ◽  
Mandy Miller Koop ◽  
Matthew C. Streicher ◽  
Anson B. Rosenfeldt ◽  
Jay L. Alberts

2018 ◽  
Author(s):  
Rafael B. Stern ◽  
Matheus d’Alencar ◽  
Yanina L. Uscapi ◽  
Marco D. Gubitoso ◽  
Antonio C. Roque ◽  
...  

ObjectiveTo investigate the use of the Goalkeeper Game (GG) to assess gait automaticity decline under dual task conditions in people with Parkinson’s disease (PPD) and compare its predictive power with the one of the MoCA test.Materials and Methods74 PPD (H&Y stages: 23 in stage 1; 31 in stage 2; 20 in stage 3), without dementia (MoCA cut-off 23), tested in ON period with dopaminergic medication were submitted to single individual cognitive/motor evaluation sessions. The tests applied were: MoCA, GG, dynamic gait index (DGI) task and timed up and go test (TUG) under single and dual-task (DT) conditions. GG test resulted in 9 measures extracted via a statistical model. The predictive power of the GG measures and the MoCA score with respect to gait performance, as assessed by DGI and DT-TUG, were compared.ResultsThe predictive models based on GG measures and MoCA score obtained, respectively, sensitivities of 65% and 56% for DGI scores and 59% and 57% for DT-TUG cost at a 50% specificity. GG application proved to be feasible and aroused more motivation in PPDs than MoCa.ConclusionGG, a friendly and ludic game, was able to reach a good power of gait performance prediction in people at initial and intermediate stages of PD evolution.


2019 ◽  
Vol 13 (1) ◽  
pp. 1-10
Author(s):  
Carolina R. A. Silveira ◽  
Eric A. Roy ◽  
Quincy J. Almeida

Background: Gait impairment is suggested to predict the onset of dementia in Parkinson’s disease (PD). Interestingly, studies have shown that PD patients with cognitive deficits mediated by posterior brain areas are at greater risk of developing dementia than those with frontal deficits. Yet, it remains unknown whether PD patients with posterior cognitive deficits show differences in gait when compared to those with frontal deficits. Aim: This study aimed to compare gait of individuals with PD showing “posterior”, “frontal”, or no cognitive impairment (NCI). Methods: Based on a sample of 64 individuals with PD, median scores were calculated for three neuropsychological tests relying on “frontal” and three relying on “posterior” brain areas. Individuals assigned into the Frontal or Posterior groups showed at least 2 out of 3 scores lower than the median in frontal or posterior tests, respectively. Those with 0 or 1 score lower than the median were classified as NCI. Participants walked under single and dual task conditions. Results: All groups walked slower, with greater variability, wider base of support, and longer double support in the dual task condition.  Interpretation: PD patients with posterior cognitive deficits walk similarly to those with frontal deficits and those with normal cognition.


Author(s):  
Robbin Romijnders ◽  
Elke Warmerdam ◽  
Clint Hansen ◽  
Julius Welzel ◽  
Gerhard Schmidt ◽  
...  

Abstract Background Identification of individual gait events is essential for clinical gait analysis, because it can be used for diagnostic purposes or tracking disease progression in neurological diseases such as Parkinson’s disease. Previous research has shown that gait events can be detected from a shank-mounted inertial measurement unit (IMU), however detection performance was often evaluated only from straight-line walking. For use in daily life, the detection performance needs to be evaluated in curved walking and turning as well as in single-task and dual-task conditions. Methods Participants (older adults, people with Parkinson’s disease, or people who had suffered from a stroke) performed three different walking trials: (1) straight-line walking, (2) slalom walking, (3) Stroop-and-walk trial. An optical motion capture system was used a reference system. Markers were attached to the heel and toe regions of the shoe, and participants wore IMUs on the lateral sides of both shanks. The angular velocity of the shank IMUs was used to detect instances of initial foot contact (IC) and final foot contact (FC), which were compared to reference values obtained from the marker trajectories. Results The detection method showed high recall, precision and F1 scores in different populations for both initial contacts and final contacts during straight-line walking (IC: recall $$=$$ = 100%, precision $$=$$ = 100%, F1 score $$=$$ = 100%; FC: recall $$=$$ = 100%, precision $$=$$ = 100%, F1 score $$=$$ = 100%), slalom walking (IC: recall $$=$$ = 100%, precision $$\ge$$ ≥ 99%, F1 score $$=$$ = 100%; FC: recall $$=$$ = 100%, precision $$\ge$$ ≥ 99%, F1 score $$=$$ = 100%), and turning (IC: recall $$\ge$$ ≥ 85%, precision $$\ge$$ ≥ 95%, F1 score $$\ge$$ ≥ 91%; FC: recall $$\ge$$ ≥ 84%, precision $$\ge$$ ≥ 95%, F1 score $$\ge$$ ≥ 89%). Conclusions Shank-mounted IMUs can be used to detect gait events during straight-line walking, slalom walking and turning. However, more false events were observed during turning and more events were missed during turning. For use in daily life we recommend identifying turning before extracting temporal gait parameters from identified gait events.


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