Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.
School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Gait Posture. 2024 May;110:48-52. doi: 10.1016/j.gaitpost.2024.03.002. Epub 2024 Mar 6.
Gait and cognition are closely associated in Parkinson's disease (PD), with specific cognitive domains being associated with different motor symptoms. By identifying gait parameters affected by cognition, clinicians can develop targeted interventions that address cognitive impairment, improve gait, and reduce the risk of injury in PD patients.
What gait parameters are affected by cognition in PD patients during dual-task walking, and how are these parameters related to cognitive function as measured by the Montreal Cognitive Assessment (MoCA)?
36 patients with available gait data and cognitive assessments were enrolled. Gait data of usual and dual-task walking sessions were recorded using lightweight wireless wearable sensors attached to trunk, lower, and upper extremities. Dual-task costs were calculated from usual and dual-task measures. Statistical analysis included non-parametric tests, Wilcoxon signed-rank test, Spearman's correlation, and stepwise linear regression models.
Walking speed, cadence, asymmetry in arm swing (ASA), between arms' amplitude symmetry (BAS), average stride time, and jerk of the acceleration movement of the legs were found to be affected during the dual-task walking session (P<0.05). Spearman's correlation showed significant correlations between MoCA scores and ASA (ρ=-0.469, P=0.036) and BAS (ρ=-0.448, P=0.036) costs. Stepwise linear regression models found that MoCA scores were significant predictors of BAS and ASA costs (P<0.05).
This study found a significant association between global cognitive ability and several gait parameters costs under cognitive load caused by dual-task walking in PD patients. The study identified the gait parameters that were affected by cognitive load and found that MoCA scores were significant predictors of those gait parameters. Identifying gait parameters affected by cognition can lead to more targeted interventions for improving gait and reducing injury risk in PD patients.
在帕金森病（PD）中，步态和认知密切相关，特定的认知领域与不同的运动症状相关。通过确定受认知影响的步态参数，临床医生可以制定针对认知障碍的靶向干预措施，改善步态，降低 PD 患者受伤的风险。
在 PD 患者进行双重任务行走时，哪些步态参数受认知影响，这些参数与蒙特利尔认知评估（MoCA）测量的认知功能有何关系？
纳入了 36 名具有可用步态数据和认知评估的患者。使用附着在躯干、下肢和上肢的轻便无线可穿戴传感器记录了常规和双重任务行走期间的步态数据。从常规和双重任务测量中计算双重任务成本。统计分析包括非参数检验、Wilcoxon 符号秩检验、Spearman 相关和逐步线性回归模型。
在双重任务行走期间发现行走速度、步频、手臂摆动不对称（ASA）、手臂间振幅对称性（BAS）、平均步幅时间和腿部加速度运动的抖动受到影响（P<0.05）。Spearman 相关显示 MoCA 评分与 ASA（ρ=-0.469，P=0.036）和 BAS（ρ=-0.448，P=0.036）成本之间存在显著相关性。逐步线性回归模型发现 MoCA 评分是 BAS 和 ASA 成本的显著预测因子（P<0.05）。
本研究发现，在 PD 患者进行认知负荷下的双重任务行走时，整体认知能力与几个步态参数成本之间存在显著关联。该研究确定了受认知负荷影响的步态参数，发现 MoCA 评分是这些步态参数的显著预测因子。确定受认知影响的步态参数可以为改善 PD 患者的步态和降低受伤风险提供更有针对性的干预措施。
