Parkinson’s gait kinematics deteriorates across multiple cognitive domains under dual-task paradigms

• Published in: Clinical neurology and neurosurgery Vol. 197; p. 106083
• Main Authors: Penko, Amanda L., Streicher, Matthew C., Dey, Tanujit, Rosenfeldt, Anson B., Alberts, Jay L.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2020; Elsevier Limited
• Subjects: Ankle; Biomechanics; Cognition; Cognition & reasoning; Cognitive ability; Data collection; Dual-task; Fitness equipment; Gait; Hip; Information processing; Kinematics; Knee; Memory; Mental task performance; Movement disorders; Neurodegenerative diseases; Neurology; Parkinson's disease; Quality of life; Range of motion; Software; Statistical analysis; Therapeutic applications; Velocity; Walking; Dual-task; Cognition; Gait; Parkinson’s disease; Kinematics
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2020.106083

•Gait velocity decreased under a range of cognitive dual-task conditions.•Joint range of motion decreased under a range of cognitive dual-task conditions.•Hip flexion was affected more than the ankle or knee under all dual-task conditions.•Cognitive scores were similar between single-task and dual-task conditions. The symptoms of Parkinson’s disease (PD) in many circumstances lead to gait dysfunction which contribute to decreased mobility, reduced quality of life, and increased risk of falling. Dual-task conditions have been shown to amplify gait dysfunction from a spatiotemporal parameter standpoint; however, less is known regarding gait joint kinematics under dual-task conditions in PD, specifically across multiple cognitive domains. The purpose of this project was to systematically characterize lower extremity joint kinematics in individuals with mild-moderate PD under dual-task paradigms across multiple cognitive domains. Twenty-three individuals with idiopathic Parkinson’s disease participated in this observational study evaluating hip, knee, and ankle joint kinematics while walking on a self-paced treadmill under dual-task conditions that taxed memory, attention, verbal fluency, and information processing. Gait velocity and range of motion at the ankle, knee, and hip decreased (p < 0.05) under all of the dual-task conditions. Hip kinematics were affected to a greater extent than the ankle and knee, with reduction in flexion and extension during all timestamps of the gait cycle (p < 0.05) under all dual-task conditions. The worsening of gait kinematics under dual-task conditions regardless of the aspect of cognition being challenged suggest that information processing and motor output are unable to withstand dual-task loads without consequence. These study results provide insight for target areas to focus on during therapeutic interventions in order to help minimize gait kinematic decrements observed under dual-task conditions.