Lin Yen-Po, Lin I-I, Chiou Wei-Da, Chang Hsiu-Chen, Chen Rou-Shayn, Lu Chin-Song, Chang Ya-Ju
Department of Medical Education, National Cheng Kung University Hospital, Tainan 704, Taiwan.
Department of Medical Education, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
Healthcare (Basel). 2023 Feb 14;11(4):567. doi: 10.3390/healthcare11040567.
To safely walk in a community environment requires dual cognitive-walking ambulation ability for people with Parkinson's disease (PD). A past study showed inconsistent results on cognitive-walking performance for PD patients, possibly due to the various cognitive tasks used and task priority assignment. This study designed cognitive-walking tests that used executive-related cognitive tasks to evaluate patients with early-stage Parkinson's disease who did not have obvious cognitive deficits. The effect of assigning task prioritization was also evaluated. Sixteen individuals with PD (PD group) and 16 individuals without PD (control group) underwent single cognitive tests, single walking tests, dual walking tests, and prioritizing task tests. Three types of cognitive, spatial memory, Stroops, and calculation tasks were employed. The cognitive performance was evaluated by response time, accuracy, and speed-accuracy trade off composite score. The walking performance was evaluated by the temporal spatial gait characteristics and variation in gait. The results showed that the walking performance of the PD group was significantly worse than the control group in both single and dual walking conditions. The group difference in cognitive performance was shown in composite score under the dual calculation walking task but not under the single task. While assigning priority to walking, no group difference in walking was observed but the response accuracy rate of PD groups declined. This study concluded that the dual task walking test could sharpen the cognitive deficits for early-stage PD patients. The task priority assignment might not be recommended while testing gait deficits since it decreased the ability to discriminate group differences.
对于帕金森病（PD）患者而言，要在社区环境中安全行走需要具备双重认知 - 行走移动能力。过去的一项研究显示，PD患者在认知 - 行走表现方面的结果并不一致，这可能是由于所使用的各种认知任务以及任务优先级分配所致。本研究设计了认知 - 行走测试，采用与执行功能相关的认知任务来评估无明显认知缺陷的早期帕金森病患者。同时还评估了任务优先级分配的影响。16名PD患者（PD组）和16名非PD患者（对照组）接受了单项认知测试、单项行走测试、双重行走测试以及任务优先级测试。采用了三种类型的认知任务，即空间记忆、斯特鲁普任务和计算任务。通过反应时间、准确性以及速度 - 准确性权衡综合得分来评估认知表现。通过时空步态特征和步态变化来评估行走表现。结果表明，在单项和双重行走条件下，PD组的行走表现均显著差于对照组。在双重计算行走任务下，认知表现存在组间差异，但在单项任务下则不存在。当将行走设为优先任务时，未观察到行走方面的组间差异，但PD组的反应准确率下降。本研究得出结论，双重任务行走测试可以凸显早期PD患者的认知缺陷。在测试步态缺陷时，可能不建议进行任务优先级分配，因为这会降低区分组间差异的能力。
