The 2-Min Walk Test Detects Dual-Task Deficits in Individuals With Parkinson’s Disease

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.

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

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2004.09.006 ◽

2005 ◽

Vol 11 (2) ◽

pp. 95-99 ◽

Cited By ~ 89

Author(s):

Colleen G. Canning

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dual Task ◽

Task Conditions ◽

Directing Attention

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Regularity of kinematic data between single and dual-task treadmill walking in people with Parkinson’s disease

Journal of NeuroEngineering and Rehabilitation ◽

10.1186/s12984-021-00807-5 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Samira Ahmadi ◽

Tarique Siragy ◽

Julie Nantel

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Time Delay ◽

Dual Task ◽

Multiple Scales ◽

Linear Acceleration ◽

Center Of Gravity ◽

Complexity Index ◽

Gait Feature ◽

Task Conditions

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.

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Effects of dance on gait and dual-task gait in Parkinson’s disease

10.21203/rs.2.15431/v1 ◽

2019 ◽

Author(s):

Nadeesha Kalyani Hewa Haputhanthirige ◽

Karen Sullivan ◽

Gene Moyle ◽

Sandy Brauer ◽

Erica Rose Jeffrey ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dual Task ◽

Verbal Fluency ◽

Large Scale ◽

Mixed Model ◽

Linear Mixed Model ◽

Step Length ◽

Gait Velocity ◽

Control Group

Abstract Background Gait impairments in Parkinson’s disease (PD) limit independence and quality of life. While dance based interventions could improve gait, further studies are needed to determine if the benefits generalise to different terrains and when dual-tasking. The aim was to perform a feasibility study of the effects of a dance intervention, based on the Dance for PD®(DfPD®) program, on gait under different dual-tasks (verbal fluency, serial subtraction) and surfaces (even, uneven), and to determine if a larger scale follow-up RCT is warranted.Methods A dance group (DG; n = 17; age = 65.8 ± 11.7 years) and a control group (CG: n = 16; age = 67.0 ± 7.7 years) comprised of non-cognitively impaired (Addenbrooke’s score: DG = 93.2 ± 3.6, CG = 92.6 ± 4.3) independently locomoting people with PD (Hoehn & Yahr I-III) participated in the study. The DG undertook a one-hour DfPD®based class, twice weekly for 12 weeks. The CG had treatment as usual. Gait analysis was performed at baseline and post-intervention while walking on two surfaces (even, uneven) under three conditions (regular walking; dual-task: verbal-fluency, serial-subtraction). The data was analysed by means of a linear mixed model. ResultsThe DG improved significantly compared to the CG in gait velocity, cadence, step-length, and stride-length when even surface walking, with and without a dual-task. On the uneven surface the DG walked more cautiously during regular walking but had improved gait velocity, cadence and step-length when performing serial-subtractions. Conclusions DfPD®-based classes produced clinically significant improvement on spatiotemporal gait parameters under dual-task conditions and on uneven surfaces. This could arise from improved movement confidence and coordination; emotional expression; cognitive skills (planning, multitasking), and; utilisation of external movement cues. A large-scale RCT of this program is warranted.Trial registration A protocol for this study has been registered retrospectively at Australian New Zealand Clinical Trials Registry on 12.11.2018. Identifier: ACTRN12618001834246.

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Cognitive and Motor Dual Task on Multi-area Brain Activation and Gait Performance in Individuals with Parkinson’s Disease

10.21203/rs.3.rs-258545/v1 ◽

2021 ◽

Author(s):

Yan-Ci Liu ◽

Yea-Ru Yang ◽

Nai-Chen Yeh ◽

Pei-Hsin Ku ◽

Chia-Feng Lu ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dual Task ◽

Near Infrared ◽

Cognitive Task ◽

Premotor Cortex ◽

Brain Activation ◽

Functional Near Infrared Spectroscopy ◽

Gait Performance ◽

Walking Performance

Abstract Background In people with Parkinson’s disease (PD), gait performance deteriorating during dual task walking compared to single-task walking has been noted in previous studies. However, the effects of different types of dual task on gait performance and brain activation were still unknown. Methods This study investigated the walking performance changes and multi-area brain activities during cognitive and motor dual task walking in people with PD. Twenty-eight participants with PD were recruited and performed single walking (SW), walking while performing a cognitive task (WCT), and walking while performing a motor task (WMT) at their self-selected speed. Gait performance including walking speed, cadence, stride length, stride time, swing cycle, temporal and spatial variability and dual task cost (DTC) were recorded. Brain activation of the prefrontal cortex (PFC), premotor cortex (PMC), and supplementary motor areas (SMA) were measured by functional near-infrared spectroscopy during walking. Results Results showed the walking performance deteriorated upon performing a secondary task, especially the cognitive task. Also, a higher and sustained activation in PMC and SMA during WCT as compared with WMT and SW in the late phase of walking was found. Moreover, gait performance was negatively correlated with PMC and SMA activity during different walking tasks. Conclusions Individuals with PD demonstrated gait deterioration during dual task walking, especially WCT. The SMA and PMC were further activated in people with PD when performing cognitive dual task walking. Trial registrationTCTR20190118010. Registered 18 January 2019, retrospectively registered.

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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

Neurorehabilitation and Neural Repair ◽

10.1177/1545968321999053 ◽

2021 ◽

pp. 154596832199905

Author(s):

Hanna Johansson ◽

Urban Ekman ◽

Linda Rennie ◽

Daniel S. Peterson ◽

Breiffni Leavy ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dual Task ◽

Cognitive Task ◽

Neuropsychological Test ◽

Cognitive Status ◽

Future Studies ◽

Task Effects ◽

Disease Patterns ◽

Affective Symptoms

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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A Review of Dual-Task Walking Deficits in People with Parkinson's Disease: Motor and Cognitive Contributions, Mechanisms, and Clinical Implications

Parkinson s Disease ◽

10.1155/2012/918719 ◽

2012 ◽

Vol 2012 ◽

pp. 1-14 ◽

Cited By ~ 57

Author(s):

Valerie E. Kelly ◽

Alexis J. Eusterbrock ◽

Anne Shumway-Cook

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dual Task ◽

Functional Mobility ◽

Therapeutic Interventions ◽

Motor Tasks ◽

Concurrent Tasks ◽

Task Conditions ◽

Gait Impairments

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.

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P2.058 Effects of a new approach to improve the gait performance in dual-task conditions for patients with Parkinson's disease

Parkinsonism & Related Disorders ◽

10.1016/s1353-8020(08)70288-8 ◽

2008 ◽

Vol 14 ◽

pp. S58

Author(s):

C. Bedeschi ◽

J. Ibrahim ◽

C.A. Cardoso ◽

B.D. Loureiro ◽

E. Okamoto ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dual Task ◽

New Approach ◽

Gait Performance ◽

Task Conditions

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The Effect of a Secondary Task on Kinematics during Turning in Parkinson’s Disease with Mild to Moderate Impairment

Symmetry ◽

10.3390/sym12081284 ◽

2020 ◽

Vol 12 (8) ◽

pp. 1284

Author(s):

Francesca Nardello ◽

Emanuele Bertoli ◽

Federica Bombieri ◽

Matteo Bertucco ◽

Andrea Monte

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dual Task ◽

Secondary Task ◽

Cognitive Task ◽

Training Stimulus ◽

Motor Impairments ◽

Turn Angle ◽

Dual Tasking ◽

Spatiotemporal Parameters

Patients with Parkinson’s disease (PD) show typical gait asymmetries. These peculiar motor impairments are exacerbated by added cognitive and/or mechanical loading. However, there is scarce literature that chains these two stimuli. The aim of this study was to investigate the combined effects of a dual task (cognitive task) and turning (mechanical task) on the spatiotemporal parameters in mild to moderate PD. Participants (nine patients with PD and nine controls (CRs)) were evaluated while walking at their self-selected pace without a secondary task (single task), and while repeating the days of the week backwards (dual task) along a straight direction and a 60° and 120° turn. As speculated, in single tasking, PD patients preferred to walk with a shorter stride length (p < 0.05) but similar timing parameters, compared to the CR group; in dual tasking, both groups walked slower with shorter strides. As the turn angle increased, the speed will be reduced (p < 0.001), whereas the ground–foot contact will become greater (p < 0.001) in all the participants. We showed that the combination of a simple cognitive task and a mechanical task (especially at larger angles) could represent an important training stimulus in PD at the early stages of the pathology.

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