EFFECTS OF DUAL TASK ON GAIT INSTABILITY IN PARKINSONS DISEASE

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心机构，不一定为研究者机构。尽管福尔斯的失能作用，具体的因素，使帕金森病（PD）患者容易福尔斯仍然难以捉摸。注意力在帕金森病患者的步态障碍中起着重要作用。然而，一般来说，“双重任务”对跌倒风险的影响，更具体地说，步态不稳定性还没有得到很好的研究。为了更好地理解注意力对步态在PD中的作用，我们测试了以下假设：当PD受试者在执行具有认知挑战性的任务（CCT）时行走时，步态变异性增加，并确定哪些PD特征与双重任务执行期间的步态不稳定相关。10名特发性PD受试者在正常条件下穿着力敏鞋垫在平地上行走，同时进行CCT。在正常行走过程中，步态变异性与跌倒风险（r=.68）、疾病持续时间（r =.81）、疾病严重程度（r=. 84）、运动功能（r=.74）、心理状态、行为和情绪（r=.72）和认知功能（r=-.64）。在双任务行走期间，步态变异性和患者特征之间的相关性降低;只有疾病持续时间仍然显著相关。这些结果突出了注意力和“双重任务”对行走的深刻影响，并表明认知挑战时行走明显加剧了步态变异性，并损害了PD患者维持稳定行走的能力。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Despite the incapacitating effects of falls, the specific factors that predispose patients with Parkinson's disease (PD) to falls remains elusive. Attention plays an important role in the gait disturbances of patients with Parkinson's disease. However, the effects of "dual tasking" on fall risk, in general, and, gait instability, more specifically, have not been well studied. To better understand the role of attention on gait in PD, we tested the hypothesis that gait variability increases when subjects with PD walk while performing a cognitively challenging task (CCT) and determined which PD features are associated with gait instability during dual task performance. Ten subjects with idiopathic PD walked on level ground while wearing force sensitive insoles under normal conditions and while performing a CCT. During normal walking, gait variability was significantly correlated with fall risk (r=.68), disease duration (r =.81), disease severity (r=. 84), motor function (r=.74), mentation, behavior and mood (r=.72) and cognitive function (r=-.64).During dual task walking, gait variability increased significantly. During dual task walking, the correlations between gait variability and patient characteristics were reduced; only disease duration remained significantly associated. These results highlight the profound effects of attention and "dual tasking" on walking and indicate that walking while cognitively challenged markedly exacerbates gait variability and impairs the ability of patients with PD to maintain a stable walk.