Improving Dual-Task Control with a Posture-Second Strategy in Early-Stage Parkinson’s Disease

Publication date: Available online 31 March 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Cheng-Ya Huang, Yu-An Chen, Ing-Shiou Hwang, Ruey-Meei Wu
ObjectiveTo examine the task prioritization effects on postural-suprapostural dual task performance in patients with early-stage Parkinson's disease (PD) without clinical observed postural symptoms.DesignCross-sectional study. Participants performed a force-matching task while standing on a mobile-platform, and were instructed to focus their attention on either the postural task (posture-first strategy) or the force-matching task (posture-second strategy).SettingUniversity research laboratory.Participants16 individuals with early-stage PD who has no clinical observed postural symptoms.InterventionsNot applicable.Main Outcome MeasuresDual-task change (DTC, % change between single-task and dual-task performance) of posture error, posture approximate entropy (ApEn), force error, and reaction time (RT). Positive DTC values indicate higher postural error, posture ApEn, force error, and force RT during dual-task conditions compared to single-task conditions.ResultsCompared to the posture-first strategy, the posture-second strategy was associated with smaller DTC of posture error and force error, and greater DTC of posture ApEn. In contrast, greater DTC of force RT was observed under posture-second strategy.ConclusionsContrary to typical recommendations, our results suggest that the posture-second strategy may be an effective dual-task strategy in patients with early-stage PD who has no clinical observed postural symptoms in order to reduce the negative effect of dual-tasking on performance and facilitate postural automaticity.



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