Freezing of gait in Parkinson’s disease: implications for dual-task walking

Andrew S. Monaghan, Anjanibhargavi Ragothaman, Graham R. Harker, Patricia Carlson-Kuhta, Fay B. Horak, Daniel S. Peterson*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

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.


Original languageEnglish
Pages (from-to)1035-1046
Number of pages12
JournalJournal of Parkinson's Disease
Volume13
Issue number6
DOIs
Publication statusPublished - Jul 2023
Externally publishedYes

Keywords

  • cognition
  • gait
  • locomotion
  • Parkinson disease
  • freezing of gait
  • cognitive impairment
  • cognitive dysfunction

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

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