Dual vs. Single Tasking During Circular Walking: What Better Reflects Progression in Parkinson's Disease?

M Encarna Micó-Amigo, Idsart Kingma, Sebastian Heinzel, Susanne Nussbaum, Tanja Heger, Rob C van Lummel, Daniela Berg, Walter Maetzler, Jaap H van Dieën

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background and Aim: Reliable, valid and sensitive measures of dual-task-associated impairments in patients with Parkinson's disease (PD) may reveal progressive deficits unnoticed under single-task walking. The aim of this study was to quantitatively identify markers of progressive gait deficits in idiopathic PD while walking over a circular trajectory condition in single-task walking and in different dual-task conditions: (1) circular walking while checking boxes on a paper sheet as fast as possible and (2) circular walking while performing subtraction of 7 as fast as possible. In addition, we aimed to study the added value of dual-tasking assessment over single (circular) walking task assessment in the study of PD progression. Methods: The assessments were performed every 6 months over a (up to) 5 years period for 22 patients in early-stage PD, 27 patients in middle-stage PD and 25 healthy controls (HC). Longitudinal changes of 27 gait features extracted from accelerometry were compared between PD groups and HCs using generalized estimating equations analysis, accounting for gait speed, age, and levodopa medication state confounders when required. In addition, dual-task-interference with gait and cognitive performance was assessed, as well as their combination. Results: The results support the validity and robustness of some of the gait features already identified in our previous work as progression markers of the disease in single-task circular walking. However, fewer gait features from dual-task than from single-task assessments were identified as markers of progression in PD. Moreover, we did not clearly identify progressive worsening of dual-task-interference in patients with PD, although some group differences between early and middle stages of PD vs. the control group were observed for dual-task interference with the gait task and with the concurrent tasks. Conclusions: Overall, the results showed that dual-tasking did not have added value in the study of PD progression from circular gait assessments. Our analyses suggest that, while single-task walking might be sensitive enough, dual-tasking may introduce additional (error) variance to the data and may represent complex composite measures of cognitive and motor performance.

Original languageEnglish
Article number372
Pages (from-to)1-19
Number of pages19
JournalFrontiers in Neurology
Volume10
DOIs
Publication statusPublished - 14 May 2019

Fingerprint

Walking
Parkinson Disease
Gait
Disease Progression
Accelerometry
Levodopa
Reproducibility of Results
Control Groups

Cite this

Micó-Amigo, M Encarna ; Kingma, Idsart ; Heinzel, Sebastian ; Nussbaum, Susanne ; Heger, Tanja ; van Lummel, Rob C ; Berg, Daniela ; Maetzler, Walter ; van Dieën, Jaap H. / Dual vs. Single Tasking During Circular Walking : What Better Reflects Progression in Parkinson's Disease?. In: Frontiers in Neurology. 2019 ; Vol. 10. pp. 1-19.
@article{a4fe939691ca4a4aafdb9c5d23d568b4,
title = "Dual vs. Single Tasking During Circular Walking: What Better Reflects Progression in Parkinson's Disease?",
abstract = "Background and Aim: Reliable, valid and sensitive measures of dual-task-associated impairments in patients with Parkinson's disease (PD) may reveal progressive deficits unnoticed under single-task walking. The aim of this study was to quantitatively identify markers of progressive gait deficits in idiopathic PD while walking over a circular trajectory condition in single-task walking and in different dual-task conditions: (1) circular walking while checking boxes on a paper sheet as fast as possible and (2) circular walking while performing subtraction of 7 as fast as possible. In addition, we aimed to study the added value of dual-tasking assessment over single (circular) walking task assessment in the study of PD progression. Methods: The assessments were performed every 6 months over a (up to) 5 years period for 22 patients in early-stage PD, 27 patients in middle-stage PD and 25 healthy controls (HC). Longitudinal changes of 27 gait features extracted from accelerometry were compared between PD groups and HCs using generalized estimating equations analysis, accounting for gait speed, age, and levodopa medication state confounders when required. In addition, dual-task-interference with gait and cognitive performance was assessed, as well as their combination. Results: The results support the validity and robustness of some of the gait features already identified in our previous work as progression markers of the disease in single-task circular walking. However, fewer gait features from dual-task than from single-task assessments were identified as markers of progression in PD. Moreover, we did not clearly identify progressive worsening of dual-task-interference in patients with PD, although some group differences between early and middle stages of PD vs. the control group were observed for dual-task interference with the gait task and with the concurrent tasks. Conclusions: Overall, the results showed that dual-tasking did not have added value in the study of PD progression from circular gait assessments. Our analyses suggest that, while single-task walking might be sensitive enough, dual-tasking may introduce additional (error) variance to the data and may represent complex composite measures of cognitive and motor performance.",
author = "Mic{\'o}-Amigo, {M Encarna} and Idsart Kingma and Sebastian Heinzel and Susanne Nussbaum and Tanja Heger and {van Lummel}, {Rob C} and Daniela Berg and Walter Maetzler and {van Die{\"e}n}, {Jaap H}",
year = "2019",
month = "5",
day = "14",
doi = "10.3389/fneur.2019.00372",
language = "English",
volume = "10",
pages = "1--19",
journal = "Frontiers in Neurology",
issn = "1664-2295",
publisher = "Frontiers Media S.A.",

}

Dual vs. Single Tasking During Circular Walking : What Better Reflects Progression in Parkinson's Disease? / Micó-Amigo, M Encarna; Kingma, Idsart; Heinzel, Sebastian; Nussbaum, Susanne; Heger, Tanja; van Lummel, Rob C; Berg, Daniela; Maetzler, Walter; van Dieën, Jaap H.

In: Frontiers in Neurology, Vol. 10, 372, 14.05.2019, p. 1-19.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Dual vs. Single Tasking During Circular Walking

T2 - What Better Reflects Progression in Parkinson's Disease?

AU - Micó-Amigo, M Encarna

AU - Kingma, Idsart

AU - Heinzel, Sebastian

AU - Nussbaum, Susanne

AU - Heger, Tanja

AU - van Lummel, Rob C

AU - Berg, Daniela

AU - Maetzler, Walter

AU - van Dieën, Jaap H

PY - 2019/5/14

Y1 - 2019/5/14

N2 - Background and Aim: Reliable, valid and sensitive measures of dual-task-associated impairments in patients with Parkinson's disease (PD) may reveal progressive deficits unnoticed under single-task walking. The aim of this study was to quantitatively identify markers of progressive gait deficits in idiopathic PD while walking over a circular trajectory condition in single-task walking and in different dual-task conditions: (1) circular walking while checking boxes on a paper sheet as fast as possible and (2) circular walking while performing subtraction of 7 as fast as possible. In addition, we aimed to study the added value of dual-tasking assessment over single (circular) walking task assessment in the study of PD progression. Methods: The assessments were performed every 6 months over a (up to) 5 years period for 22 patients in early-stage PD, 27 patients in middle-stage PD and 25 healthy controls (HC). Longitudinal changes of 27 gait features extracted from accelerometry were compared between PD groups and HCs using generalized estimating equations analysis, accounting for gait speed, age, and levodopa medication state confounders when required. In addition, dual-task-interference with gait and cognitive performance was assessed, as well as their combination. Results: The results support the validity and robustness of some of the gait features already identified in our previous work as progression markers of the disease in single-task circular walking. However, fewer gait features from dual-task than from single-task assessments were identified as markers of progression in PD. Moreover, we did not clearly identify progressive worsening of dual-task-interference in patients with PD, although some group differences between early and middle stages of PD vs. the control group were observed for dual-task interference with the gait task and with the concurrent tasks. Conclusions: Overall, the results showed that dual-tasking did not have added value in the study of PD progression from circular gait assessments. Our analyses suggest that, while single-task walking might be sensitive enough, dual-tasking may introduce additional (error) variance to the data and may represent complex composite measures of cognitive and motor performance.

AB - Background and Aim: Reliable, valid and sensitive measures of dual-task-associated impairments in patients with Parkinson's disease (PD) may reveal progressive deficits unnoticed under single-task walking. The aim of this study was to quantitatively identify markers of progressive gait deficits in idiopathic PD while walking over a circular trajectory condition in single-task walking and in different dual-task conditions: (1) circular walking while checking boxes on a paper sheet as fast as possible and (2) circular walking while performing subtraction of 7 as fast as possible. In addition, we aimed to study the added value of dual-tasking assessment over single (circular) walking task assessment in the study of PD progression. Methods: The assessments were performed every 6 months over a (up to) 5 years period for 22 patients in early-stage PD, 27 patients in middle-stage PD and 25 healthy controls (HC). Longitudinal changes of 27 gait features extracted from accelerometry were compared between PD groups and HCs using generalized estimating equations analysis, accounting for gait speed, age, and levodopa medication state confounders when required. In addition, dual-task-interference with gait and cognitive performance was assessed, as well as their combination. Results: The results support the validity and robustness of some of the gait features already identified in our previous work as progression markers of the disease in single-task circular walking. However, fewer gait features from dual-task than from single-task assessments were identified as markers of progression in PD. Moreover, we did not clearly identify progressive worsening of dual-task-interference in patients with PD, although some group differences between early and middle stages of PD vs. the control group were observed for dual-task interference with the gait task and with the concurrent tasks. Conclusions: Overall, the results showed that dual-tasking did not have added value in the study of PD progression from circular gait assessments. Our analyses suggest that, while single-task walking might be sensitive enough, dual-tasking may introduce additional (error) variance to the data and may represent complex composite measures of cognitive and motor performance.

U2 - 10.3389/fneur.2019.00372

DO - 10.3389/fneur.2019.00372

M3 - Article

VL - 10

SP - 1

EP - 19

JO - Frontiers in Neurology

JF - Frontiers in Neurology

SN - 1664-2295

M1 - 372

ER -