Dual Task Cost with assistive device use in people with Parkinson's disease and community-dwelling older adults

This study compares the effects of assistive devices (ADs) on mobility and dual-task performance in individuals with and without Parkinson's disease. We hypothesize that bilateral ADs will increase time and dual-task (DT) performance in both groups, with greater changes in people with Parkinson's disease (PwPD).

This quasi-experimental study assessed performance on the Timed-Up-and-Go with AD (TUG) and Timed-Up-and-Go-Cognitive (TUG-COG) across six different assistive devices in two groups: PwPD (n = 11, 73.4 ± 4.92 years); older adults without PD (n = 7, 72.1 ± 8.4 years).

A repeated measures ANOVA with Bonferroni correction showed a significant main effect of ADs on TUG and TUG-COG time (both p < 0.001). In PwPD, TUG with AD time differed significantly between devices: single-point cane and large-based quad cane (LBQC) (p = 0.044), pick-up walker (PUW) (p = 0.001), rollator (p = 0.014), and LBQC and PUW (p = 0.007). Friedman's ANOVA revealed significant differences in TUG-COG across devices in PwPD (p < 0.001) and older adults (p = 0.003). No significant differences in the effect of assistive devices were found between PwPD and older adults.

Bilateral ADs, such as the pick-up walker, led to larger differences in TUG performance compared to unilateral devices. Most outcomes were similar between groups, suggesting device choice, rather than the diagnosis of Parkinson's disease, may impact performance in the earlier stages of the diagnosis.