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Impact of dual-tasking on mobility tasks in Parkinson's disease as described through 2D kinematic analysis
Christina Criminger1, Chad Swank2
1Department of Physical Therapy, Winston-Salem State University, 346 FL Atkins Bldg., 601 Martin Luther King Drive, Winston-Salem, NC, 27110, USA. crimingercm@wssu.edu.
Background:
Walking for people with Parkinson's disease (PD) degrades during motor-cognitive interplay (i.e., dual task conditions). Declining gait mechanics and turning ability result in more frequent falls and an interruption of daily activities in persons with PD.
Aims:
To determine the impact of dual-tasking on key mobility elements during a walking task in people with PD with 2D motion analysis.
Methods:
Participants performed Timed Up and Go (TUG) single, dual task conditions (TUGalone, TUGmotor, and TUGcognitive). 2D motion analysis application was used to quantify seven key mobility elements including: sit-to-walk (STW) (s), walking turn time (WTT) (s), number of turn steps, turn-to-sit (TTS) (s), total number of TUG steps, total TUG time and turn strategy (on-the-spot or u-shaped).
Results:
Thirty-one participants with PD completed this study [age M= 69 ± 8.19, UPDRSm M= 23.21 ± 10.03, HY MED= 2 (range 1-4)]. All key elements were significantly different between TUG conditions with the exception of sit-to-walk and turn strategy. Turn strategy was consistent across TUG tasks despite added cognitive loading. Repeated-measures MANOVA differences were observed in WTT (p = 0.01), number of turn steps (p = 0.03), TTS (p < 0.001), total number of TUG steps (p = 0.01), and total TUG time (p = 0.01). No significant relationships were found between disease severity (HY/UPDRSm) and turn strategy.
Discussion/Conclusion:
Key mobility elements were significantly affected across dual task walking conditions in persons with PD. The use of 2D motion analysis assisted with identification of key mobility elements impacted during the single and dual task conditions.