To investigate the effect of task prioritization on dual-task control in Parkinson disease (PD) associated with different postural impairments.
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).
University research laboratory.
Fifteen patients with PD and less postural impairment and 15 patients with PD and more postural impairment (N=30).
Main Outcome Measures
Postural sway, postural determinism (%DET), ankle co-contraction, and ring-touching time.
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.
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.
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)
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Published online: March 28, 2020
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.
© 2020 by the American Congress of Rehabilitation Medicine