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. 2021 Nov;128(11):1677-1685.
doi: 10.1007/s00702-021-02393-1. Epub 2021 Jul 29.

Dual task gait deteriorates gait performance in cervical dystonia patients: a pilot study

Oscar Crisafulli  1 , Carlo Trompetto  1   2 , Luca Puce  1 , Lucio Marinelli  1   2 , Stefania Costi  1   3 , Giovanni Abbruzzese  1 , Laura Avanzino  4   5 , Elisa Pelosin  1   2
Affiliations

Dual task gait deteriorates gait performance in cervical dystonia patients: a pilot study

Oscar Crisafulli et al. J Neural Transm (Vienna). 2021 Nov.

Abstract

Day-to-day walking-related activities frequently involve the simultaneous performance of two or more tasks (i.e., dual task). Dual task ability is influenced by higher order cognitive and cortical control mechanisms. Recently, it has been shown that the concomitant execution of an attention-demanding task affected postural control in subject with cervical dystonia (CD). However, no study has investigated whether dual tasking might deteriorate gait performance in CD patients. To investigate whether adding a concomitant motor and cognitive tasks could affect walking performance in CD subjects.17 CD patients and 19 healthy subjects (HS) participated in this pilot case-control study. Gait performance was evaluated during four walking tasks: usual, fast, cognitive dual task and obstacle negotiation. Spatiotemporal parameters, dual-task cost and coefficients of variability (CV%) were measured by GaitRite® and were used to detect differences between groups. Balance performance was also assessed with Mini-BEST and Four Step Square tests. In CD participants, correlation analysis was computed between gait parameters and clinical data. Significant differences in complex gait and balance performance were found between groups. CD patients showed lower speed, longer stance time and higher CV% and dual-task cost compared to HS. In CD, altered gait parameters correlated with balance performance and were not associated with clinical features of CD. Our findings suggest that complex walking performance is impaired in patients with CD and that balance and gait deficits might be related.

Keywords: Balance; Cervical dystonia; Dual task; Gait; Motor-cognitive.

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Conflict of interest statement

The Authors have no known conflicts of interest associated with this publication. Financial interests: the authors have no financial interest to declare that are relevant to the content of this article. Non-financial interests: Pelosin E is an unpaid member of the gait advisory committee for the MJ FOX foundation.

Figures

Fig. 1
Fig. 1
Representative image of gait assessment. The subjects were asked to walk on the GAITRite carpet n various conditions; (A) usual walk, walk to their own pace; (B) fast walk, walk to their maximum speed, not running; (C) verbal dual task, walk while saying the highest possible number of words beginning with a letter referred by the operator right before the beginning of the trial; (D) obstacle crossing task, walk crossing an obstacle placed 3 m from the start of the mat. The order of the task was randomly assigned
Fig. 2
Fig. 2
Mean values of the: (A) Mini Best Test (score), (B) Four-Square Step Test (FSST; seconds) for each group are reported. Light gray columns refer to cervical dystonia (CD) group, dark gray columns refer to healthy subjects (HS) group. Black bars represent standard deviation (SD). CD patients exhibited a lower score in the Mini Best Test and longer time to complete the FSST. Asterisks indicate significant differences between groups (*p < 0.01; ** p < 0.0001)
Fig. 3
Fig. 3
Significant correlations (after Bonferroni correction) between altered gait parameters and balance performance. Panel (A) and (B) correlation between Mini Best score (Y-axis) and gait speed and stride length CV% (X-axis) respectively. Panel (C) and (D) correlation between the FFST time (Y-axis) and stance time CV% and stride length CV% (X-axis) respectively
See this image and copyright information in PMC

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