TY - JOUR
T1 - Dual-Task Costs of Quantitative Gait Parameters while Walking and Turning in People with Parkinson's Disease
T2 - Beyond Gait Speed
AU - Vitorio, Rodrigo
AU - Hasegawa, Naoya
AU - Carlson-Kuhta, Patricia
AU - Nutt, John G.
AU - Horak, Fay B.
AU - Mancini, Martina
AU - Shah, Vrutangkumar V.
N1 - Funding Information:
The authors thank all participants for generously donating their time to participate, Peter Fino, Carolin Curtze, Mike Fleming, Heather Schlueter, Peter Martin and Graham Harker for helping with data collection, Daniel Peterson and Katrijn Smulders for data collection and help with study procedures, and Edward King for helping with data collection and management. This research was funded by the National Institutes of Health under award number R01AG006457 (PI: Horak), and Department of Veterans Affairs Merit Award number 5I01RX001075 (PI: Horak).
PY - 2021/4/13
Y1 - 2021/4/13
N2 - Background: There is a lack of recommendations for selecting the most appropriate gait measures of Parkinson's disease (PD)-specific dual-task costs to use in clinical practice and research. Objective: We aimed to identify measures of dual-task costs of gait and turning that best discriminate performance in people with PD from healthy individuals. We also investigated the relationship between the most discriminative measures of dual-task costs of gait and turning with disease severity and disease duration. Methods: People with mild-to-moderate PD (n=144) and age-matched healthy individuals (n=79) wore 8 inertial sensors while walking under single and dual-task (reciting every other letter of the alphabet) conditions. Outcome measures included 26 objective measures within four gait domains (upper/lower body, turning and variability). The area under the curve (AUC) from the receiver-operator characteristic plot was calculated to compare discriminative ability of dual-task costs on gait across outcome measures. Results: PD-specific, dual-task interference was identified for arm range of motion, foot strike angle, turn velocity and turn duration. Arm range of motion (AUC=0.73) and foot strike angle (AUC=0.68) had the largest AUCs across dual-task costs measures and they were associated with disease severity and/or disease duration. In contrast, the most commonly used dual-task gait measure, gait speed, showed an AUC of only 0.54. Conclusion: Findings suggest that people with PD rely more than healthy individuals on executive-attentional resources to control arm swing, foot strike, and turning, but not gait speed. The dual-task costs of arm range of motion best discriminated people with PD from healthy individuals.
AB - Background: There is a lack of recommendations for selecting the most appropriate gait measures of Parkinson's disease (PD)-specific dual-task costs to use in clinical practice and research. Objective: We aimed to identify measures of dual-task costs of gait and turning that best discriminate performance in people with PD from healthy individuals. We also investigated the relationship between the most discriminative measures of dual-task costs of gait and turning with disease severity and disease duration. Methods: People with mild-to-moderate PD (n=144) and age-matched healthy individuals (n=79) wore 8 inertial sensors while walking under single and dual-task (reciting every other letter of the alphabet) conditions. Outcome measures included 26 objective measures within four gait domains (upper/lower body, turning and variability). The area under the curve (AUC) from the receiver-operator characteristic plot was calculated to compare discriminative ability of dual-task costs on gait across outcome measures. Results: PD-specific, dual-task interference was identified for arm range of motion, foot strike angle, turn velocity and turn duration. Arm range of motion (AUC=0.73) and foot strike angle (AUC=0.68) had the largest AUCs across dual-task costs measures and they were associated with disease severity and/or disease duration. In contrast, the most commonly used dual-task gait measure, gait speed, showed an AUC of only 0.54. Conclusion: Findings suggest that people with PD rely more than healthy individuals on executive-attentional resources to control arm swing, foot strike, and turning, but not gait speed. The dual-task costs of arm range of motion best discriminated people with PD from healthy individuals.
KW - Cognition
KW - gait
KW - locomotion
KW - Parkinson's disease
UR - http://www.scopus.com/inward/record.url?scp=85104301428&partnerID=8YFLogxK
U2 - 10.3233/JPD-202289
DO - 10.3233/JPD-202289
M3 - Article
C2 - 33386812
AN - SCOPUS:85104301428
SN - 1877-7171
VL - 11
SP - 653
EP - 664
JO - Journal of Parkinson's Disease
JF - Journal of Parkinson's Disease
IS - 2
ER -