Interlimb coordination in Parkinson’s Disease is affected by a visuospatial dual task

Abstract

AbstractParkinson’s disease (PD) leads to reduced spatial and temporal interlimb coordination during gait as well as reduced coordination in the upper or lower limbs. While multi-tasking when walking is common during real world activities, the impact of dual-tasking (DT) on intra and interlimb coordination of both lower and upper limbs when walking in people with PD remains unknown. Seventeen volunteers with mild to moderate PD (11M, 65±8 years, 173±8 cm, 74±20 kg, UPDRS III 10±5) participated in gait trials in an Extended-CAREN system, which includes a treadmill, 12-camera Vicon motion capture system, and a 180° field-of-view virtual reality projection screen. Participants completed a 3 min walking trial, and a 2 min visuospatial word recognition DT trial at their preferred walking pace. Single and DT were compared with a paired t-test. During DT, we found the less affected (LA) shoulder ROM decreased by 1.5°, the LA shoulder peak flexion decreased by 1.1°, the LA hip ROM decreased by 0.99° (p<.04, gav>.12), and hip ROM asymmetry decreased by 0.96° (p=.01, gav=.24). Upper and lower intralimb phase variability on the LA side increased 3.8° and 0.94°, respectively, during DT (p<.03, gav>.28). These results suggest that during normal single-task gait, people with PD use attentional resources to compensate for deficits in spatial and temporal coordination. Furthermore, our results may indicate that compensating for deficits in coordination is a higher priority than minimizing asymmetry in gait.Summary statementA dual-task during gait disrupted attempts to compensate for spatial and temporal coordination deficits on the less affected side in a group of people with mild to moderate Parkinson’s disease.