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Aging Clinical and Experimental Research

, Volume 30, Issue 9, pp 1137–1142 | Cite as

Analyzing gait variability and dual-task interference in patients with Parkinson’s disease and freezing by means of the word-color Stroop test

  • Ana Francisca Rozin Kleiner
  • Aline S. Pagnussat
  • Giulia di Prisco
  • Alessandro Vagnini
  • Fabrizio Stocchi
  • Maria Francesca De Pandis
  • Manuela Galli
Original Article

Abstract

The ability to carry out two tasks at once is critical to effective functioning in the real world and deficits are termed Dual-task interference or effect—DTE. DTE substantially compromised the gait of subjects with Parkinson’s disease and freezing of gait (PD + FOG), leading to exaggerated slowing, increasing gait dysrhythmicity, and inducing FOG episodes. This study aimed to investigate the DTE in gait variability of subjects with PD and freezing of gait (PD + FOG). Thirty-three patients with PD + FOG and 14 healthy individuals (REFERENCE) took part at this study. Two gait conditions were analyzed: usual walking (single task) and walking while taking the word-color Stroop test (dual task). The computed variables were as follows: gait velocity, step length, step timing, gait asymmetry, variability measures and DTE of each variable. The PD + FOG group has presented negative DTE values for all analyzed variables, indicating dual task cost. The REFERENCE group has presented dual-task benefits for step length standard deviation and step time. Differences between both groups and conditions were found for all variables, except for step time. Taking the word-color Stroop test while walking led to a larger dual-task cost in subjects with PD + FOG.

Keywords

Parkinson’s disease Freezing of gait Gait Dual task Word-color Stroop test 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

The present study complied with ethical standards and participants provided informed consent.

References

  1. 1.
    Beauchet O, Berrut G (2006) Gait and dual-task: definition, interest, and perspectives in the elderly. Psychol Neuropsychiatr Vieil 4:215–225PubMedGoogle Scholar
  2. 2.
    Djamshidian A, O’Sullivan SS, Lees A, Averbeck BB (2011) Stroop test performance in impulsive and non impulsive patients with Parkinson’s disease. Parkinsonism Relat Disord 17:212–214.  https://doi.org/10.1016/j.parkreldis.2010.12.014 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Hsieh YH, Chen KJ, Wang CC, Lai CL (2008) Cognitive and motor components of response speed in the stroop test in Parkinson’s disease patients. Kaohsiung J Med Sci 24:197–203.  https://doi.org/10.1016/S1607-551X(08)70117-7 CrossRefPubMedGoogle Scholar
  4. 4.
    Cohen RG, Klein KA, Nomura M et al (2014) Inhibition, executive function, and freezing of gait. J Parkinsons Dis 4:111–122.  https://doi.org/10.3233/JPD-130221 PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Kelly VE, Eusterbrock AJ, Shumway-Cook A (2012) The effects of instructions on dual-task walking and cognitive task performance in people with Parkinson’s disease. Parkinsons Dis  https://doi.org/10.1155/2012/671261 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Spildooren J, Vercruysse S, Desloovere K, et al (2010) Freezing of gait in Parkinson’s disease: the impact of dual-tasking and turning. Mov Disord 25:2563–2570.  https://doi.org/10.1002/mds.23327 CrossRefPubMedGoogle Scholar
  7. 7.
    Yogev G, Giladi N, Peretz C et al (2005) Dual tasking, gait rhythmicity, and Parkinson’s disease: which aspects of gait are attention demanding? Eur J Neurosci 22:1248–1256.  https://doi.org/10.1111/j.1460-9568.2005.04298.x CrossRefPubMedGoogle Scholar
  8. 8.
    Hausdorff JM, Schaafsma JD, Balash Y et al (2003) Impaired regulation of stride variability in Parkinson’s disease subjects with freezing of gait. Exp Brain Res 149:187–194.  https://doi.org/10.1007/s00221-002-1354-8 CrossRefPubMedGoogle Scholar
  9. 9.
    Nanhoe-Mahabier W, Snijders AH, Delval A et al (2011) Walking patterns in Parkinson’s disease with and without freezing of gait. Neuroscience 182:217–224.  https://doi.org/10.1016/j.neuroscience.2011.02.061 CrossRefPubMedGoogle Scholar
  10. 10.
    Plotnik M, Giladi N, Balash Y et al (2005) Is freezing of gait in Parkinson’s disease related to asymmetric motor function? Ann Neurol 57:656–663. DOI:  https://doi.org/10.1002/ana.20452 CrossRefPubMedGoogle Scholar
  11. 11.
    Plotnik M, Giladi N, Hausdorff JM (2008) Bilateral coordination of walking and freezing of gait in Parkinson’s disease. Eur J Neurosci 27:1999–2006.  https://doi.org/10.1111/j.1460-9568.2008.06167.x CrossRefPubMedGoogle Scholar
  12. 12.
    Plotnik M, Hausdorff JM (2008) The role of gait rhythmicity and bilateral coordination of stepping in the pathophysiology of freezing of gait in Parkinson’s disease. Mov Disord 23:S444–S450.  https://doi.org/10.1002/mds.21984 CrossRefPubMedGoogle Scholar
  13. 13.
    Peterson DS, King LA, Cohen RG, et al (2016) Cognitive contributions to freezing of gait in Parkinson disease: implications for physical rehabilitation. Phys Ther 96:659–670.  https://doi.org/10.2522/ptj.20140603 CrossRefPubMedGoogle Scholar
  14. 14.
    Nutt JG, Bloem BR, Giladi N, et al (2011) Freezing of gait: moving forward on a mysterious clinical phenomenon. Lancet Neurol 10:734–744.  https://doi.org/10.1016/S1474-4422(11)70143-0 CrossRefPubMedGoogle Scholar
  15. 15.
    Wu T, Hallett M, Chan P (2015) Motor automaticity in Parkinson’s disease. Neurobiol Dis 82:226–234.  https://doi.org/10.1016/j.nbd.2015.06.014 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Fling BW, Cohen RG, Mancini M et al (2014) Functional reorganization of the locomotor network in Parkinson patients with freezing of gait. PLoS One 9:e100291.  https://doi.org/10.1371/journal.pone.0100291 CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Rochester L, Galna B, Lord S, et al (2014) The nature of dual-task interference during gait in incident parkinson’s disease. Neuroscience 265:83–94.  https://doi.org/10.1016/j.neuroscience.2014.01.041 CrossRefPubMedGoogle Scholar
  18. 18.
    Parkinson’s Disease: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care. London: Royal College of Physicians of London 2006Google Scholar
  19. 19.
    Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Goetz CG, Tilley BC, Shaftman et al (2008) Movement disorder society-sponsored revision of the unified Parkinson’s disease rating scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord 23:2129–2170.  https://doi.org/10.1002/mds.22340 CrossRefPubMedGoogle Scholar
  21. 21.
    Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442CrossRefPubMedGoogle Scholar
  22. 22.
    Giladi N, Shabtai H, Simon ES, et al (2000) Construction of freezing of gait questionnaire for patients with Parkinsonism. Parkinsonism Relat Disord 6:165–170CrossRefPubMedGoogle Scholar
  23. 23.
    Ounpuu S, Gage JR, Davis RB (1991) Three-dimensional lower extremity joint kinetics in normal pediatric gait. J Pediatr Orthop 11:341–349CrossRefPubMedGoogle Scholar
  24. 24.
    Almeida QJ, Lebold CA (2010) Freezing of gait in Parkinson’s disease: a perceptual cause for a motor impairment? J Neurol Neurosurg Psychiatry 81:513–518.  https://doi.org/10.1136/jnnp.2008.160580 CrossRefPubMedGoogle Scholar
  25. 25.
    Okada Y, Fukumoto T, Takatori K, et al (2011) Abnormalities of the first three steps of gait initiation in patients with Parkinson’s disease with freezing of gait. Parkinsons Dis  https://doi.org/10.4061/2011/202937 PubMedPubMedCentralCrossRefGoogle Scholar
  26. 26.
    Kelly VE, Janke AA, Shumway-Cook A (2010) Effects of instructed focus and task difficulty on concurrent walking and cognitive task performance in healthy young adults. Exp Brain Res 207:65–73.  https://doi.org/10.1007/s00221-0102429-6 CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Plummer P, Eskes G (2015) Measuring treatment effects on dual-task performance: a framework for research and clinical practice. Front Hum Neurosci 9:1–7.  https://doi.org/10.3389/fnhum.2015.00225 CrossRefGoogle Scholar
  28. 28.
    Taylor R (1999) Interpretation of the correlation coefficient: a basic review. JDMS 1:35–39Google Scholar
  29. 29.
    Bond JM, Morris M (2000) Goal-directed secondary motor tasks: their effects on gait in subjects with Parkinson disease. Arch Phys Med Rehabil 81:110–116CrossRefPubMedGoogle Scholar
  30. 30.
    Hausdorff JM, Nelson ME, Kaliton D et al (2001) Etiology and modification of gait instability in older adults: a randomized controlled trial of exercise. J Appl Physiol 90:2117–2129CrossRefPubMedGoogle Scholar
  31. 31.
    Hausdorff JM, Rios DA, Edelberg HK (2001) Gait variability and fall risk in community-living older adults: a 1 year prospective study. Arch Phys Med Rehabil 82:1050–1056.  https://doi.org/10.1053/apmr.2001.24893 CrossRefPubMedGoogle Scholar
  32. 32.
    Holmes JD, Jenkins ME, Johnson AM, et al (2010) Dual-task interference: the effects of verbal cognitive tasks on upright postural stability in Parkinson’s disease. Parkinsons Dis  https://doi.org/10.4061/2010/696492 PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Dipartimento di Elettronica, Informazione e BioingegneriaPolitecnico di MilanoMilanoItaly
  2. 2.Movement Analysis and Neurological Rehabilitation LaboratoryUniversidade Federal de Ciencias da Saude de Porto AlegrePorto AlegreBrazil
  3. 3.IRCCS San Raffaele PisanaRomaItaly
  4. 4.San Raffaele Cassino, Tosinvest SanitàCassinoItaly

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