1. Secondary task performance during challenging walking tasks and freezing episodes in Parkinson’s disease
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Jorik Nonnekes, Claudia Stummer, Bastiaan R. Bloem, Vivian Weerdesteyn, Valeria Dibilio, and Linda C. A. Drenthen
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Male ,Parkinson's disease ,Neurology ,genetic structures ,Walking ,Electromyography ,Severity of Illness Index ,Executive functions ,0302 clinical medicine ,Aged, 80 and over ,Freezing of gait ,medicine.diagnostic_test ,05 social sciences ,Parkinson Disease ,Cognition ,Middle Aged ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,Psychiatry and Mental health ,Female ,Psychology ,Algorithms ,medicine.medical_specialty ,Secondary task ,Clinical Neurology ,Gait disorders ,Stimulus (physiology) ,Neurology and Preclinical Neurological Studies - Original Article ,050105 experimental psychology ,03 medical and health sciences ,Physical medicine and rehabilitation ,Reaction Time ,medicine ,Humans ,0501 psychology and cognitive sciences ,Freezing Reaction, Cataleptic ,Delayed reaction ,Gait Disorders, Neurologic ,Biological Psychiatry ,Aged ,Analysis of Variance ,medicine.disease ,Acoustic Stimulation ,Parkinson’s disease ,Physical therapy ,Neurology (clinical) ,human activities ,Psychomotor Performance ,030217 neurology & neurosurgery - Abstract
Contains fulltext : 168134.pdf (Publisher’s version ) (Open Access) Parkinson's disease (PD) patients likely use attentional strategies to compensate for their gait deficits, which increases the cognitive challenge of walking. The interplay between cognitive functions and gait can be investigated by evaluating the subject's attendance to a secondary task during walking. We hypothesized that the ability to attend to a secondary task decreases during challenging walking conditions in PD, particularly during freezing of gait (FOG)-episodes. Twenty-nine PD patients and 14 age-matched controls performed a simple reaction task that involved squeezing a ball as fast as possible in response to an auditory stimulus. Participants performed this reaction task during four conditions: (1) walking at preferred speed; (2) walking with short steps at preferred speed; (3) walking with short steps, as rapidly as possible; (4) making rapid full turns. We used surface electromyography to determine reaction times, and a pressure sensor located within the ball to determine movement onset. Reaction times of PD patients were slower (on average by 42 ms) compared to controls, regardless of the walking task. In both groups, reaction times were significantly longer during the turning condition compared to all other conditions. FOG-episodes were most often seen during the turning condition. In PD patients, reaction times were significantly longer during FOG-episodes compared to trials without FOG. Our results suggest that turning requires more attentional resources than other walking tasks. The observation of delayed reaction times during FOG-episodes compared to trials without FOG suggests that freezers use additional resources to overcome their FOG-episodes.
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