Effects of pathway shape and dual-tasking on spatiotemporal gait parameters in individuals with Parkinson's disease

Examining the effects of different pathway shapes on walking performance, particularly under cognitive load, is important for understanding motor control in individuals with Parkinson's disease (PD) under real-life conditions. This study aimed to investigate the effects of walking on different pathway shapes and dual-tasking (DT) on spatiotemporal gait parameters in individuals with PD.

A prospective cross-sectional observational study was conducted with 50 individuals diagnosed with PD. Participants were initially assessed using the Unified Parkinson's Disease Rating Scale (UPDRS), the Dual-Task Questionnaire (DTQ), and the Modified Gait Efficacy Scale (mGES). Subsequently, spatiotemporal characteristics of the 4-Meter Walk Test (4MWT), Timed Up and Go Test (TUG), Figure-of-8 Walk Test (F8WT), and L Test were measured under single-task and DT conditions.

In all tests, dual-task conditions significantly increased duration and step count (p < 0.05). The F8WT showed multiple spatiotemporal impairments (p < 0.05). The highest duration and step count costs were in the 4-MWT (p < 0.001), while the highest speed and step length costs were in the TUG (p ≤ 0.030). For correlations, 4-MWT duration and step count/time positively correlated with UPDRS-III (r ≥ 0.307,p < 0.05), while F8WT cadence (r= -0.310, p = 0.034) and TUG duration (r= -0.426,p = 0.003) correlated with UPDRS-III and mGES, respectively. DTQ selectively correlated with speed and length across tests (p < 0.05).

Dual-task conditions impair both straight and shaped walking in PD. While 4-MWT exhibits higher time-space costs, DTQ and UPDRS-III selectively determine dual-task performance across different pathway shapes. Integrating both straight and curved paths under cognitive load provides a more comprehensive approach for clinical assessment and rehabilitation.