Lander Joshua J, Moran Matthew F, Alexanian Hannah R
Department of Physical Therapy and Human Movement Science, Sacred Heart University, Fairfield, Connecticut, United States of America.
Lander Sport and Health Sciences, Westport, Connecticut, United States of America.
PLoS One. 2025 Jun 13;20(6):e0317389. doi: 10.1371/journal.pone.0317389. eCollection 2025.
Cognitive impairments and gait disturbances are often concurrent in Parkinson disease (PD), but the extent to which specific cognitive deficits relate to gait abnormalities remains unclear, especially in early-stage PD. To address this gap, we conducted an observational correlational study to determine if cognitive performance in distinct domains is associated with gait kinematics in PD. This study included a cohort of 19 individuals with early-stage PD who underwent gait analysis with a three-dimensional marker-less motion capture system (Theia Markerless Inc., Kingston, ON, CA) during three conditions: single-task walking, cognitive dual-task walking, and the Timed Up and Go (TUG) test. Cognitive abilities were assessed using computerized tests (Creyos, Toronto, ON, CA) of working memory (WM), response inhibition (RI), and mental rotation (MR). We found that higher WM scores significantly correlated with better gait performance under dual-task conditions, including faster gait velocity (r = 0.6524, p = 0.0025), longer stride length (r = 0.6758, p = 0.0015), higher toe clearance (r = 0.5234, p = 0.0215), and greater hip range of motion (ROM) (r = 0.6803, p = 0.0014). Similarly, better MR ability was associated with longer stride length (r = 0.5178, p = 0.0231) and greater hip ROM (r = 0.4886, p = 0.0338) during dual-task walking. Furthermore, superior WM and MR performance were linked to faster TUG completion times, particularly during the second walking phase of the TUG (WM: r = -0.682, p = 0.0013; MR: r = -0.6755, p = 0.002). These results indicate that WM and MR may be linked to gait performance in PD, especially during cognitively challenging walking tasks. These findings may have clinical, rehabilitative, and neuroscientific utility for those involved in the study and management of PD.
认知障碍和步态障碍在帕金森病(PD)中常常同时出现,但特定认知缺陷与步态异常的关联程度仍不明确,尤其是在早期帕金森病中。为了填补这一空白,我们进行了一项观察性相关性研究,以确定不同领域的认知表现是否与帕金森病患者的步态运动学相关。本研究纳入了19名早期帕金森病患者,他们在三种情况下接受了使用三维无标记运动捕捉系统(Theia Markerless Inc.,加拿大安大略省金斯顿)进行的步态分析:单任务步行、认知双任务步行和定时起立行走测试(TUG)。使用计算机化测试(Creyos,加拿大安大略省多伦多)评估工作记忆(WM)、反应抑制(RI)和心理旋转(MR)的认知能力。我们发现,在双任务条件下,较高的WM分数与更好的步态表现显著相关,包括更快的步态速度(r = 0.6524,p = 0.0025)、更长的步幅(r = 0.6758,p = 0.0015)、更高的足尖离地高度(r = ?0.5234,p = 0.0215)和更大的髋关节活动范围(ROM)(r = 0.6803,p = 0.0014)。同样,在双任务步行过程中,更好的MR能力与更长的步幅(r = 0.5178,p = 0.0231)和更大的髋关节ROM(r = 0.4886,p = 0.0338)相关。此外,较高的WM和MR表现与更快的TUG完成时间相关,特别是在TUG的第二个步行阶段(WM:r = -0.682,p = 0.0013;MR:r = -0.6755,p = 0.002)。这些结果表明,WM和MR可能与帕金森病患者的步态表现相关,尤其是在具有认知挑战性的步行任务中。这些发现可能对参与帕金森病研究和管理的人员具有临床、康复和神经科学方面的实用价值。 (注:原文中“r = ?0.5234”疑似有误,已按正确格式翻译,但此处可能影响理解,需结合原文核对)