Background: Decline in mobility functions is common with aging and in a number of central nervous system disorders, such as Parkinson’s disease (PD). Simultaneous control of sensory-motor resources and executive cognitive functions (ECF) is required for safe outdoor walking. Such dual-task (DT) situations, especially the DT walking tasks are often associated with increased risk of falling. There is a need to establish a DT assessment protocol to test the effectiveness of DT interventions in reducing gait instability and fall risk in PD and older adults. A Computer Game-Based Rehabilitation System (GRP) has been developed for assessing balance, gait and ECF simultaneously in individuals with PD and older adults.
Purpose: The purpose of this study was to examine the effects of age and basal ganglia pathology on the magnitude of Dual-Task Interference (DTI) on balance, gait and ECF.
Methods: 31 healthy older adults (mean age, 67.5±6.9 years) were recruited for this study. This data sample was compared to an existing dataset of individuals diagnosed with PD (stage-2 and 3, H&Y scale). Dual task performance was evaluated during sponge standing and treadmill walking combined with visuospatial and visuomotor cognitive tasks.
Results: A significant DTI was observed for gait and cognitive outcome measures in all groups. A significantly greater magnitude of DTI on balance, gait and cognition was found in participants with PD as compared to similar aged healthy controls (AHC). This study shows that the magnitude of DTI on pathology is more pronounced in stage 3 PD as compared to their AHC. There was no difference in magnitude of DTI between stage 2 PD and their AHC. Conclusion: GRP can be used as a screening tool to detect mobility impairments and assess fall risk during healthy aging and early stages of PD.