This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Despite the incapacitating effects of falls, the specific factors that predispose patients with Parkinson's disease (PD) to falls remains elusive. Attention plays an important role in the gait disturbances of patients with Parkinson's disease. However, the effects of 'dual tasking' on fall risk, in general, and, gait instability, more specifically, have not been well studied. To better understand the role of attention on gait in PD, we tested the hypothesis that gait variability increases when subjects with PD walk while performing a cognitively challenging task (CCT) and determined which PD features are associated with gait instability during dual task performance. Ten subjects with idiopathic PD walked on level ground while wearing force sensitive insoles under normal conditions and while performing a CCT. During normal walking, gait variability was significantly correlated with fall risk (r=.68), disease duration (r =.81), disease severity (r=. 84), motor function (r=.74), mentation, behavior and mood (r=.72) and cognitive function (r=-.64).During dual task walking, gait variability increased significantly. During dual task walking, the correlations between gait variability and patient characteristics were reduced; only disease duration remained significantly associated. These results highlight the profound effects of attention and 'dual tasking' on walking and indicate that walking while cognitively challenged markedly exacerbates gait variability and impairs the ability of patients with PD to maintain a stable walk.
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