Effects of cognitive task on gait initiation in Parkinson disease: Evidence of motor prioritization?

Joe R. Nocera, Ryan Roemmich, Jonathan Elrod, Lori J. P. Altmann, Chris J. Hass
2013 Journal of rehabilitation research and development  
While much is known about the effects of dual tasking on cyclical and continuous motor performance (e.g., locomotion), there is a paucity of information on the effect of dual tasking on the initiation of movement. Therefore, the purpose of this study was to investigate the effect of a concurrent cognitive task on gait initiation in three groups: patients with Parkinson disease, healthy older adults, and healthy young adults. We examined the anticipatory postural adjustment displacements and
more » ... cities during single-task gait initiation as well as two dual-task conditions: (1) 0-back + gait initiation and (2) 2-back + gait initiation. The Parkinson disease group exhibited less anticipatory postural adjustment displacement and velocity than their aged-matched healthy peers and young adults during the single-and dual-task gait initiation settings (p < 0.05). Of interest was the finding of no additional effect on anticipatory postural adjustment displacement or velocity of gait initiation during the dual-task conditions in any group, including the Parkinson disease group. More traditionally studied gait/balance dual-task paradigms have demonstrated both motor and cognitive decline. Therefore, our results may suggest a prioritization of more "intentional" movement task (e.g., gait initiation) while dual tasking in Parkinson disease. Abbreviations : ANOVA = analysis of variance, APA = anticipatory postural adjustments, GI = gait initiation, H&Y = Hoehn & Yahr, HOA = healthy older adults, HYA = healthy young adults, MANOVA = multivariate analysis of variance, MMSE = Mini-Mental State Examination, PD = Parkinson disease.
doi:10.1682/jrrd.2012.06.0114 pmid:24013917 fatcat:l2gmmeqcu5hxvctqmjrbvhp5eu