Dual-task interference during a functional mobility task in Parkinson's disease persists across medication states

The Stair Ambulation and Functional Evaluation of Gait (Safe-Gait) platform was developed as a comprehensive and objective assessment of functional mobility that combines stair ambulation, level-ground walking, and turning within a single assessment. This project aimed to determine the effects of antiparkinsonian medication and dual-tasking on overall time to completion and phase-specific temporal measures to objectively quantify mobility performance in people with PD.

Thirty-two people with PD completed the Safe-Gait test under single-task (ST) and dual-task (DT) conditions while ON- and OFF-antiparkinsonian medication. Completion time was the primary outcome; secondary outcomes were completion times for the six Safe-Gait phases: gait initiation, stair ascent, level-ground walking (departure & return), turning, and stair descent. A linear mixed model was used to evaluate the effects of medication and task condition.

No significant medication-by-task interaction was observed. However, main effects for task and medication were present. Completion time was 6.2% longer OFF-medication than ON-medication, with the smallest medication-related effect observed in the gait initiation phase (2%). Completion time was 13% longer under DT conditions than ST, with the largest DT interference (DTI) observed in the gait initiation phase (21%).

While dopaminergic medication improved overall functional mobility, it did not mitigate DTI. Gait initiation showed minimal responsiveness to medication and the greatest DTI, highlighting its heightened sensitivity to combined motor and cognitive demands. These findings support the Safe-Gait platform as a sensitive, ecologically valid tool for rapidly quantifying multiple aspects of functional mobility in people with PD.