Impact of Dual Task on Parkinson's Disease, Stroke and Ataxia Patients' Gait: A Comparative Analysis

Maciel, Michelly Arjona; Silva, Ana Carolina Souza Moura; Cyrillo, Fabio Navarro; Santos, Suely; Torriani-Pasin, Camila

doi:10.1590/1678-7153.201427216

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Experimental Psychology • Psicol. Reflex. Crit. 27 (02) • 2014 • https://doi.org/10.1590/1678-7153.201427216 copy

Impact of Dual Task on Parkinson's Disease, Stroke and Ataxia Patients' Gait: A Comparative Analysis

Impacto da Dupla Tarefa na Marcha de Pacientes com Doença de Parkinson, Acidente Vascular Cerebral e Ataxia: Uma Análise Comparativa

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction:

Performing dual task for neurological patients is complex and it can be influenced by the localization of the neurological lesion.

Objective:

Comparing the impact of dual task on gait in patients with Parkinson's disease, stroke and ataxia.

Method:

Subjects with Parkinson's disease (PD) in initial phase, stroke and ataxia, with independent gait, were evaluated while doing simple gait, with cognitive, motor and cognitive-motor gait demand, assessing average speed and number of steps.

Results:

Ataxia and stroke patients, compared with PD, showed an increase in the number of steps and decrease the average speed on the march with cognitive demand. Subjects with PD performed better on tasks when compared to others.

Conclusion:

In this study the impact of dual task was lower in Parkinson's disease patients.

Gait; locomotion; physiotherapy; hemiplegia; dual task

0	Stroke subjects (n = 6)	Parkinson subjects (n = 6)	Ataxia subjects (n = 6)
Age (years) Gender	56.2 (6.1)	60.7 (5.8)	53.3 (4.2)
Male	4	4	3
Female	2	2	3
Injury Time	8.3 (6.6)	12 (10.3)	5.26 (3.88)
MMSE	24 (1.1)	28 (2.3)	27 (1.0)
UPDRS		27-32
Hoehn-Yahr		1 - 1.5

Number of Steps		Average	Median	SD	CV	Q1	Q3	N	IC	p-value
Task 1Gait	Ataxia	22.17	20.50	8.75	39.5%	16.25	24.00	6	7.00	.002*^(a-c)
	PD	16.17	15.00	2.40	14.9%	15.00	15.75	6	1.92
	Stroke	27.17	23.50	9.20	33.9%	21.50	31.50	6	5.21
Task 2 Cognitive	Ataxia	26.67	28.50	7.37	27.6%	21.50	32.50	6	5.89	.019^(a-c).001^(b-c)
	PD	16.33	16.00	2.42	14.8%	15.25	17.50	6	1.94
	Stroke	28.00	23.50	9.69	34.6%	20.75	32.50	6	5.48
Task 3Motor	Ataxia	25.67	28.50	7.28	28.4%	19.75	31.25	6	5.83	.001*^(b-c)
	PD	19.33	19.00	2.25	11.6%	17.50	21.25	6	1.80
	Stroke	33.50	26.50	16.70	49.8%	23.75	39.50	6	9.45
Task 4Cognitive-Motor	Ataxia	25.33	28.50	8.21	32.4%	18.25	31.25	6	6.57	.158
	PD	22.67	22.00	5.75	25.4%	18.25	25.00	6	4.60
	Stroke	35.50	29.50	17.21	48.5%	24.50	39.25	6	9.74

Average speed		Average	Median	SD	CV	Q1	Q3	N	CI	p-value
Task 1	Ataxia	.79	.77	.41	52.3%	.53	.98	6	.33	.002*
Gait	PD	1.14	1.13	.20	17.6%	1.00	1.25	6	.16	(b-c)
	PD	1.14	1.13	.20	17.6%	1.00	1.25	6	.16	(b-c)
	stroke	.61	.64	.26	42.4%	.35	.78	6	.15
Task 2 Cognitive	Ataxia	.59	.51	.31	53.0%	.35	.86	6	.25	.003*
	PD	1.07	1.11	.06	5.3%	1.03	1.11	6	.05	(a-c)
	PD	1.07	1.11	.06	5.3%	1.03	1.11	6	.05	.001*
	stroke	.59	.66	.22	38.1%	.34	.76	6	.13	.001*
	stroke	.59	.66	.22	38.1%	.34	.76	6	.13	(b-c)
Task 3	Ataxia	.63	.57	.35	56.0%	.32	.95	6	.28	.100
Motor	PD	.77	.77	.13	16.8%	.65	.88	6	.10
	stroke	.50	.55	.23	46.5%	.23	.71	6	.13
Task 4	Ataxia	.71	.56	.42	58.4%	.40	1.05	6	.33	.193
Motor – cognitive	PD	.64	.64	.16	24.4%	.57	.66	6	.12
	stroke	.41	.46	.23	55.6%	.21	.59	6	.13

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