TY - JOUR
T1 - Freezing of Gait in Parkinson's Disease
T2 - Implications for Dual-Task Walking
AU - Monaghan, Andrew S.
AU - Ragothaman, Anjanibhargavi
AU - Harker, Graham R.
AU - Carlson-Kuhta, Patricia
AU - Horak, Fay B.
AU - Peterson, Daniel S.
N1 - Publisher Copyright:
© 2023-The authors. Published by IOS Press.
PY - 2023/9/8
Y1 - 2023/9/8
N2 - Background: The simultaneous completion of multiple tasks (dual-Tasking, DT) often leads to poorer task performance (DT cost, DTC). People with Parkinson's disease (PwPD) exhibit difficulty with DT, and DTC may be particularly pronounced in PwPD with freezing of gait (FOG). Objective: This study assessed the relationship between FOG status and DTC during gait. Methods: Gait parameters were collected using inertial sensors in 106 PwPD (off-medication), including definite-freezers (dFOG; n=25), possible-freezers (pFOG; n=16), and non-freezers (nFOG; n=65) during single (ST)-And DT walking. Results: PwPD with dFOG had larger (worse) DTC than nFOG for foot-strike angle, stride length, toe-off angle, variability of foot-strike angle, and arm range of motion (ROM). After accounting for covariates, DTC for toe-off angle and stride length remained worse in PwPD who freeze. Worse cognition predicted larger DTC for stride length, gait cycle duration, gait speed, and step duration across groups. Men had larger DTC compared to women for gait speed, variability in foot-strike angle, stride length, and arm ROM. Increased variability in gait speed DTC was associated with increased disease severity. Conclusion: These findings provide additional support that PwPD who freeze may rely on greater cortical control for the execution of specific gait metrics. The results also underscore the importance of considering cognition when assessing DT ability in PwPD.
AB - Background: The simultaneous completion of multiple tasks (dual-Tasking, DT) often leads to poorer task performance (DT cost, DTC). People with Parkinson's disease (PwPD) exhibit difficulty with DT, and DTC may be particularly pronounced in PwPD with freezing of gait (FOG). Objective: This study assessed the relationship between FOG status and DTC during gait. Methods: Gait parameters were collected using inertial sensors in 106 PwPD (off-medication), including definite-freezers (dFOG; n=25), possible-freezers (pFOG; n=16), and non-freezers (nFOG; n=65) during single (ST)-And DT walking. Results: PwPD with dFOG had larger (worse) DTC than nFOG for foot-strike angle, stride length, toe-off angle, variability of foot-strike angle, and arm range of motion (ROM). After accounting for covariates, DTC for toe-off angle and stride length remained worse in PwPD who freeze. Worse cognition predicted larger DTC for stride length, gait cycle duration, gait speed, and step duration across groups. Men had larger DTC compared to women for gait speed, variability in foot-strike angle, stride length, and arm ROM. Increased variability in gait speed DTC was associated with increased disease severity. Conclusion: These findings provide additional support that PwPD who freeze may rely on greater cortical control for the execution of specific gait metrics. The results also underscore the importance of considering cognition when assessing DT ability in PwPD.
KW - Cognition
KW - Parkinson's disease
KW - cognitive dysfunction
KW - cognitive impairment
KW - freezing of gait
KW - gait
KW - locomotion
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U2 - 10.3233/JPD-230063
DO - 10.3233/JPD-230063
M3 - Article
C2 - 37574744
AN - SCOPUS:85170582164
SN - 1877-7171
VL - 13
SP - 1037
EP - 1048
JO - Journal of Parkinson's Disease
JF - Journal of Parkinson's Disease
IS - 6
ER -