Does the type of concurrent task affect preferred and cued gait in people with Parkinson's disease?

Abstract

Difficulty performing more than one task at a time is common in people with Parkinson's disease, resulting in interference with one or both tasks. While studies have shown that greater interference in gait occurs with more complex concurrent tasks, the impact of the type of concurrent task is unclear in the Parkinson's population. Thus the first purpose of this study was to investigate the effect of the concurrent task (calculation, language, or motor) on gait in people with Parkinson's disease. As visual cues are commonly used to aid stride regulation in people with Parkinson's disease, the second purpose of this study was to determine whether this method of increasing stride length was still effective if other tasks were performed simultaneously. Sixteen patients with Parkinson's disease and 16 gender- and age-matched controls performed six cognitive and motor concurrent tasks when seated, walking 10 m, and walking over visual cues. Stride length decreased in people with Parkinson's disease when performing the concurrent calculation and language tasks, but not with the motor task. The language task was more complex than the calculation task, thus the effect was not due to task complexity alone. Visual cues were effective in improving stride length whilst maintaining velocity in people with Parkinson's disease, even when performed under dual task conditions. These findings highlight the importance of the task when assessing and retraining dual tasking during gait, and suggest that retraining dual tasking can occur whilst simultaneously using visual aids to regulate stride length.

Effect of concurrent walking and interlocutor distance on conversational speech intensity and rate in Parkinson's disease

“…A substantial amount of research has been dedicated to investigating the effects of concurrent tasks on walking performance because individuals with PD are considered to be at an increased risk for falls during concurrent activities (Bloem et al, 2004;Morris et al, 1996). The results of these studies provide consistent evidence that talking (or performing other types of concurrent tasks) significantly deteriorates walking performance (Galletly & Brauer, 2005;O'Shea et al, 2002;Rochester et al, 2004;Morris et al, 1996;Bloem et al, 2004).…”

“…The few studies that have provided analysis for the speech task have been inconsistent, and the type of speech task may explain this variability. For example, Galletly and Brauer (2005) Only two studies have been conducted to determine the effects of a concurrent task that is specifically focused on motor speech production in PD, and the results are inconsistent. Ho, Iansek, and Bradshaw (2002) examined the effect of a concurrent manual task on speech intensity in individuals with PD using two speech tasks, conversation and a loud numerical recitation task.…”

“…Consequently, when individuals with PD attempt dual tasking, their footsteps become short and slow (Galletly & Brauer, 2005;O'Shea et al, 2002), ground clearance reduced, and they become at an increased risk for falls (Bloem, Hausdorff, Visser, & Giladi, 2004;Morris et al, 1996).…”

A Study on the Effects of Argentine Tango as a Form of Partnered Dance for those with Parkinson Disease and the Healthy Elderly

“…Freezing also commonly occurs with gait initiation and when walking through doorways or other tight spaces. Individuals with PD have difficulty walking in dual task conditions as well (Galletly and Brauer 2005;Canning 2005;Rochester et al 2004;O'Shea et al 2002). Gait speed, stride length and stability decrease when individuals with PD are placed in dual task conditions.…”

Parkinson's disease treatments: focus on transcranial direct current stimulation (tDCS)

“…Several clinical trials indicate cueing therapy-induced improvements in walking speed, step length, and frequency in PD. [43][44][45][46] From a neuroanatomical perspective, enhanced activation of the premotor cortex seems to be relevant for the improvement of motor performance induced by cueing therapy. 47 Thus, Costa-Ribeiro et al 29 investigated the effects of tDCS combined with cued gait training (CGT) on functional mobility in patients with PD.…”