title: Effects of cognitive task on gait initiation in Parkinson disease: evidence of motor prioritization?
abstract: While much is known about the effects of dual tasking on cyclical and continuous motor performance (e.g., locomotion), there is a paucity of information on the effect of dual tasking on the initiation of movement. Therefore, the purpose of this study was to investigate the effect of a concurrent cognitive task on gait initiation in three groups: patients with Parkinson disease, healthy older adults, and healthy young adults. We examined the anticipatory postural adjustment displacements and velocities during single-task gait initiation as well as two dual-task conditions: (1) 0-back + gait initiation and (2) 2-back + gait initiation. The Parkinson disease group exhibited less anticipatory postural adjustment displacement and velocity than their aged-matched healthy peers and young adults during the single- and dual-task gait initiation settings (p < 0.05). Of interest was the finding of no additional effect on anticipatory postural adjustment displacement or velocity of gait initiation during the dual-task conditions in any group, including the Parkinson disease group. More traditionally studied gait/balance dual-task paradigms have demonstrated both motor and cognitive decline. Therefore, our results may suggest a prioritization of more "intentional" movement task (e.g., gait initiation) while dual tasking in Parkinson disease.
authors.affiliation: Atlanta VA Medical Center, 1670 Clairmont Rd, MS 151R, Decatur, GA 30033. joenocera@emory.edu.
authors.forename: Joe R
authors.initials: JR
authors.lastname: Nocera
authors.forename: Ryan
authors.initials: R
authors.lastname: Roemmich
authors.forename: Jonathan
authors.initials: J
authors.lastname: Elrod
authors.forename: Lori J P
authors.initials: LJ
authors.lastname: Altmann
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Hass
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003071:Cognition / Q000502:physiology*; D005684:Gait; D006801:Humans; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology*; D004856:Postural Balance; D011597:Psychomotor Performance; D055815:Young Adult