Abstract
Objective
To investigate the effect of task prioritization on dual-task control in Parkinson
disease (PD) associated with different postural impairments.
Design
Cross-sectional study. Participants were instructed to keep 2 interlocking rings apart
and maintain balance in a tandem stance. Attention was focused on either stance stability
(posture-focus strategy) or the interlocking rings (supraposture-focus strategy).
Setting
University research laboratory.
Participants
Fifteen patients with PD and less postural impairment and 15 patients with PD and
more postural impairment (N=30).
Interventions
Not applicable.
Main Outcome Measures
Postural sway, postural determinism (%DET), ankle co-contraction, and ring-touching
time.
Results
In the less-impairment group, the supraposture-focus strategy provided smaller postural
sway and postural %DET compared with the posture-focus strategy. In the more-impairment
group, task prioritization showed lower effect on both postural sway and postural
%DET. The supraposture-focus strategy led to less ankle co-contraction than the posture-focus
strategy in the more-impairment group, but task prioritization did not affect ankle
co-contraction in the less-impairment group. In both groups, the supraposture-focus
strategy led to less ring-touching time than the posture-focus strategy.
Conclusions
The supraposture-focus strategy provided better dual-task control than the posture-focus
strategy in both PD groups. In the less-impairment group, the supraposture-focus strategy
enhanced postural automaticity and postural stability. In the more-impairment group,
the supraposture-focus strategy reduced ankle stiffness, owing to reduced muscle co-contraction.
Keywords
List of abbreviations:
ANOVA (analysis of variance), AP (anterior-posterior), CAI (co-activation index), CoP (center-of-pressure), DET (determinism), EMG (electromyography), MDS-UPDRS (MDS-sponsored Revision of the Unified Parkinson’s Disease Rating Scale), ML (medial-lateral), PD (Parkinson disease), PF (posture-focus), SF (supraposture-focus), RMS (root mean square)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 28, 2020
Footnotes
Supported by the Centre for Parkinson and Movement Disorders at National Taiwan University Hospital and the Ministry of Science and Technology, R.O.C. Taiwan (grant no. MOST 106-2314-B-002-045-MY2).
Clinical Trial Registration No.: NCT03298503.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
