Objective: To investigate the control of dual-task weight-shifting in Parkinson’s disease (PD) with freezing of gait (FOG) and without FOG).

Background: With more impairment in motor automaticity and executive function, individuals with PD and FOG require more efforts for dual-task postural control than individuals with PD who do not have FOG symptom. In most dual-task studies, the postural tasks were limited to static standing task or walking task. However, weight-shifting control is critical in functional activities in daily living and the ability of weight-shifting control is particularly challenging for freezers.

Method: This is a cross-sectional study, including 11 patients with PD who had FOG symptom (FOG+ group) and 13 patients with PD who did not have FOG symptom (FOG− group). The participants were required to perform a weight-shifting task (posture task) and a tray-rotating (supra-posture task) concurrently (Figure 1). The amplitude of the posture task was set between 10% to 90% weight bearing (Figure 2), and the amplitude of the supra-posture task was set between 45 degrees left to 45 degrees right (Figure 3). The participants conducted the dual task by coupling the weight-bearing value and tray-rotating degree to sinusoidal targets at 0.25 Hz. The tracking error and movement smoothness of the posture task and supra-posture task were measured by root mean square error and jerk value.

Results: Both posture error (p = 0.039) and supra-posture error (p < 0.001) was greater in the FOG+ group than the FOG− group. For movement smoothness, the FOG− group had a greater value of supra-posture jerk (p = 0.022) than the FOG+ group, without significant difference in posture jerk between the FOG+ group and FOG− group (p = 0.70).

Conclusion: Since greater jerk indicates more movement correction, the results of this study showed that PD without FOG had greater weight-shifting control ability with more automatic control than PD with FOG. In addition, PD without FOG could achieve better supra-posture accuracy by more frequent movement corrections.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/dual-task-interference-on-weight-shifting-in-parkinsons-disease-with-freezing-of-gait-and-without-freezing-of-gait/