Goal-directed secondary motor tasks: Their effects on gait in subjects with Parkinson disease (original) (raw)
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Physical Therapy
Background and Purpose. Exacerbation of movement disorders while doing 2 tasks (dual task performance) is a characteristic feature of Parkinson disease (PD). The aim of this investigation was to identify whether the type of secondary task (motor or cognitive) determined the severity of dual task interference. Subjects and Methods. Footstep patterns for 15 people with PD and 15 comparison subjects without PD were compared when they walked: (1) at a self-selected speed, (2) while simultaneously performing a motor task (coin transference), and (3) while simultaneously performing a cognitive task (digit subtraction). Gait speed, stride length, cadence, and the percentage of the gait cycle in double-limb stance (DS) were examined with a computerized stride analyzer. Results. When there was no second task, the mean stride length was less in the group with PD (1.29 m) than in the comparison group (1.51 m), and the mean gait speed was less in the group with PD (71.47 m/min) than in the comparison group (87.29 m/min). The mean cadence was less in the group with PD (110.79 steps/min) than in the comparison group (115.81 steps/min). The percentage of the gait cycle in DS was greater in the group with PD (33.38%) than in the comparison group (31.21%). Both groups reduced their stride length and speed when they had to change from unitask performance to dual task performance and DS increased. For the group with PD, cadence also decreased. For both groups, the type of secondary task had a negligible effect on the performance decrement. Discussion and Conclusion. Although the performance of simultaneous motor or cognitive tasks compromised gait in people with PD, the type of secondary task was not a major determinant of the severity of dual task interference. [O'Shea S, Morris ME, Iansek R. Dual task interference during gait in people with Parkinson disease: effect of motor versus cognitive secondary tasks. Phys Ther. 2002;82:888 -897.]
Dual-task demands in various motor skills through Parkinson’s disease progression
Motriz: Revista de Educação Física
The aim of this study was to investigate the effects of adding a cognitive task on the performance of three different motor tasks with different demands, discrete skills, serial skills and continuous skills, by individuals with mild, moderate, and severe idiopathic Parkinson' disease (PD). We also investigate the effect of the cognitive task in the secondary task and the cost of the dual-task. Method: This is a cross-sectional study. Individuals with idiopathic PD were divided in three groups with respect to motor severity (mild, moderate and severe groups). Participants' performances were assessed in single and DT conditions including Sit-to-Stand test (SST), Timed Up and Go (TUG), and 10-meter Walk test (T10W). Cognitive task used was verbal fluency Results: The results show that dual task impact the performance of all primary tasks. DT negatively affects the performance of the motor tasks. And there is a different impact according the severity of the disease, severe ones are more affected than mild and moderate. Conclusion: In conclusion, adding a concurrent cognitive task negatively affected the performance of discrete, serial and continuous motor tasks, and this effect is more noticeable in severe than in mild patients. Under dual-task conditions, patients improved their cognitive task performance for gait and TUG, suggesting a prioritization of the secondary task for these tasks. There was no difference between the costs of the three tasks.
The organization of stepping in patients with Parkinson's disease: bradykinesia or discoordination?
The purpose of this experiment was to quantify and analyse multijoint coordination of patients with Parkinson's disease (N=5) and control subjects (N=5) during forward and backward stepping motions executed at different cadences. Coordinates of reflective markers placed on the shoulder, hip, knee, ankle and metatarsal joints were recorded in the sagittal plane using a video motion analysis system. Kinematic and kinetic analyses provided angular displacements and velocities as well as joint moments of force and powers. Results suggest the presence of two types of discoordination: one type is velocity-dependent, hence related to bradykinesia, whereas the other type appears to reflect qualitatively different coordination patterns. RESUME: L'organisation du mouvement pour executer des pas chez les parkinsoniens: bradykinesie ou incoordination. L'objectif de cette etude etait de quantifier et d'analyser la coordination multiarticulaire de patients atteints de la maladie de Parkinson (N = 5) et de sujets controles (N = 5) pendant des mouvements d'enjambement effectues vers l'avant et Farriere a differentes cadences. Les coordonnees de marqueurs reflechissants places sur Fepaule, la hanche, le genou, la cheville et le metatarse ont ete enregistrees dans le plan sagittal a l'aide d'un systeme video informatise d'analyse du mouvement. Les analyses cinematiques et cinetiques ont permis de quantifier les deplacements et vitesses angulaires ainsi que les moments de force et la puissance au niveau des differentes articulations. Les resultats suggerent la presence de deux types d'incoordination chez ces patients: Fun depend de la vitesse d'execution du mouvement et est relie a la bradykinesie, alors que Fautre semble correspondre a des patrons de coordination qualitativement differents.
2019
Background: In Parkinson’s disease (PD) population, performing secondary tasks while walking further deteriorates gait and restrict mobility in functional contexts of daily life. This study (1) analyzed the interference of functional cognitive and motor secondary task on untrained people with PD and (2) compared their walking with healthy subjects. Methods : Forty people with PD (aged 66.72 [7.5] years, Hoehn and Yahr stage I-II-III on-medication) composed the PD group (PDG) and 43 participants (aged 66.60 [8.75] years) formed the group of healthy counterparts (HG). Gait was evaluated through spatiotemporal, kinematic and kinetic outcomes in five conditions: single task (ST) and visual, verbal, auditory and motor dual-task (DT). Results : The performance of both groups was higher in the ST than verbal, auditory and motor DT conditions (p < .05). A similar gait pattern was observed between ST and visual DT during velocity, cadence and vertical forces in PDG and HG. In addition, PD...
Force coordination during bimanual task performance in Parkinson’s disease
Experimental Brain Research, 2013
coordination, were reduced in PD patients. Discrepancies in the strength of within-hand force coordination with respect to hand action were also noted in PD patients. Increased grip force production, in conjunction with abnormal load force production, may result in reduced fine motor control in PD patients during daily activities. Integrating quantitative analyses of realistic motor function in clinic may assist clinicians in evaluating the effectiveness of medical intervention in PD patients.
Journal of motor behavior, 2016
The authors aimed to compare the postural phase of gait initiation under single-task (gait initiation) and dual-task (gait initiation plus Stroop test) conditions in healthy subjects and in subjects with Parkinson's disease (PD) in the early stages (Hoehn and Yahr scale < 3). The postural phase of gait initiation was assessed through the centre of pressure in single and dual task in 10 healthy subjects and 9 with PD. The analysis indicated that in the early stages of PD, an additional cognitive task did not affect the displacement of the gait initiation. No significant effects occurred between the groups and within-subjects (p > .05). Also, no interaction was found between the groups and the conditions (single- and dual-task). Differences were found in the duration of the mediolateral postural phase (p = .003), which was higher in PD subjects than in healthy subjects. The findings suggest that subjects in the early stages of PD prioritize gait initiation, as their motor pe...
Movement Disorders, 2002
Six patients with idiopathic Parkinson's disease (PD) and six age-matched controls participated in a variety of rhythmic bimanual coordination tasks. The main goal of the task was to perform inphase or antiphase patterns of pronation and supination of the forearms at a specified tempo, and to switch from one pattern to the other upon presentation of a visual cue. The availability of advance information was varied to examine whether deficits would emerge under choice versus pre-cue constraints. In pre-cue conditions, the subjects knew in advance which hand would be cued to initiate pattern change. In choice conditions, the cued hand was not known until the imperative stimulus was presented. Overall, the PD patients made movements with significantly lower frequencies and smaller amplitudes relative to controls. Patients exhibited spontaneous pattern switching from antiphase to inphase at significantly lower movement frequencies than controls. During intentional switching trials, the control group was significantly faster at initiating pattern change. PD and control groups differed in the time to initiate pattern switching to a greater extent under choice conditions, suggesting that patients used advance information to increase the speed of their response. The control group exhibited a preference for spontaneous switching and intentional switching through the subdominant hand. Patients exhibited a switching preference using the impaired limb (whether or not it was subdominant). The control group made more correct responses when the subdominant side was either pre-cued or presented in choice conditions. The patients maintained the subdominant/impaired side advantage under pre-cue conditions but not choice. In the maintenance of rhythmic movement, individuals with PD were able to use advance information in terms of both speed and accuracy. © 2001 Movement Disorder Society.
Impairment in bilateral alternating movements in Parkinson's disease?
Journal of Neurology, Neurosurgery & Psychiatry, 1992
Although problems in bilateral simultaneous movements in Parkinson's disease (PD) are well known, such deficits have not been reported to be any more impaired than simultaneous movements within the same limb. This is surprising, since (a) the parallels between supplementary motor area (SMA) damage and PD are well documented and (b) the SMA seems to play a special role in bilateral motor control. Bilateral versus unilateral movements in PD were examined by using a task that compared alternating movements of fingers of the same hand with alternating movements of fingers of the opposite hands. PD patients showed particular problems in programming and transferring motor activity to fingers on the opposite side of the body, as opposed to switching motor activity between fingers on the same side of the body. These findings outline the relevance of SMA dysfunction to PD.