Background:There is a lack of recommendations for selecting the most appropriate gait measures of Parkinson’s disease (PD)-specific dual-task costs to use in clinical practice and research. Objective:We aimed to identify measures of dual-task costs of gait and turning that best discriminate performance in people with PD from healthy individuals. We also investigated the relationship between the most discriminative measures of dual-task costs of gait and turning with disease severity and disease duration. Methods:People with mild-to-moderate PD (n = 144) and age-matched healthy individuals (n = 79) wore 8 inertial sensors while walking under single and dual-task (reciting every other letter of the alphabet) conditions. Outcome measures included 26 objective measures within four gait domains (upper/lower body, turning and variability). The area under the curve (AUC) from the receiver-operator characteristic plot was calculated to compare discriminative ability of dual-task costs on gait across outcome measures. Results:PD-specific, dual-task interference was identified for arm range of motion, foot strike angle, turn velocity and turn duration. Arm range of motion (AUC = 0.73) and foot strike angle (AUC = 0.68) had the largest AUCs across dual-task costs measures and they were associated with disease severity and/or disease duration. In contrast, the most commonly used dual-task gait measure, gait speed, showed an AUC of only 0.54. Conclusion:Findings suggest that people with PD rely more than healthy individuals on executive-attentional resources to control arm swing, foot strike, and turning, but not gait speed. The dual-task costs of arm range of motion best discriminated people with PD from healthy individuals.

中文翻译：

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帕金森病患者行走和转弯时定量步态参数的双重任务成本：超越步态速度

背景：对于选择用于临床实践和研究的帕金森病 (PD) 特异性双任务成本的最合适的步态测量方法缺乏建议。目的：我们的目的是确定步态和转向双重任务成本的衡量标准，以最能区分 PD 患者和健康个体的表现。我们还调查了步态和转动的双重任务成本的最具歧视性的措施与疾病严重程度和疾病持续时间之间的关系。方法：轻度至中度 PD 患者 (n = 144) 和年龄匹配的健康个体 (n = 79) 在单任务和双任务（背诵字母表中的其他字母）条件下行走时佩戴 8 个惯性传感器。结果测量包括四个步态域（上/下身、转动和可变性）内的 26 个客观测量。计算接收者-操作者特征图的曲线下面积 (AUC) 以比较双任务成本对跨结果测量的步态的辨别能力。结果：确定了针对手臂运动范围、脚触角、转动速度和转动持续时间的 PD 特异性双任务干扰。在双任务成本测量中，手臂活动范围 (AUC = 0.73) 和足部触角 (AUC = 0.68) 具有最大的 AUC，它们与疾病严重程度和/或疾病持续时间相关。相比之下，最常用的双任务步态测量步态速度显示的 AUC 仅为 0.54。结论：研究结果表明，与健康人相比，PD 患者更多地依赖执行注意力资源来控制手臂摆动、足部撞击和转动，而不是步态速度。