A meta-analysis: Parkinson's disease and dual-task walking

Abstract

A growing body of literature has reported the effects of dual tasks on gait performance in people with Parkinson's disease (PD). The purpose of this meta-analysis was to synthesize the existing literature and quantify the overall influence of dual tasks on gait performance in PD. A thorough literature search was conducted, and 19 studies met the stringent inclusion criteria. Two moderator variable analyses examined the dual-task effect by: (a) mean single-task gait speed for each study (≥1.1 m/s or < 1.1 m/s), and (b) the type of dual task (arithmetic, language, memory, and motor). Three main findings were revealed by a random effects model analysis. First, a strong negative effect of dual tasks on walking performance (SMD = -0.68) confirmed that gait performance is adversely affected by dual tasks in people with PD. Second, the significant negative effect of dual tasks is present regardless of the mean level of single-task gait speed in a study. Third, dual-task walking speed deteriorates regardless of the type of dual task. Together, these results confirm that dual tasks severely affect walking performances in people with PD.

Keywords: Cognition; Dual-task; Interference; Parkinson's; Walk.

Figure 1.

Search procedure and results according to PRISMA guidelines [26].

Figure 2.

Forest plot of random effects model of 19 studies. Overall SMD is represented by a diamond on the bottom of the graph. SMD= Standardized Mean Difference, CI= 95% Confidence Interval, RW = Relative Weight.

Figure 3.

Trim and fill funnel plot of the comparison for random effects model. The x-axis indicates the SMD and the y-axis shows the standard error for each comparison. The white diamond on the x-axis represents the standardized effects of the 28 comparisons (SMD = −0.68) while the black diamonds represent the adjusted standardized effect (SMD =−0.53) after imputing ten values.