Objective: This study investigated the influence of cognitive function on obstacle crossing performance in people with Parkinson’s disease (PD).

Background: Obstacle-crossing is a complex motor task that involves both motor and cognitive function. Nearly a third of falls in people with PD were related to tripping over obstacles. Compared to healthy ones, people with PD present shorter stride length, slower stride velocity and wider step width during obstacle crossing. However, the impact of cognition on obstacle-crossing performance in people with PD has not been well documented.

Method: This cross-sectional study recruited 34 subjects who were diagnosed with idiopathic PD. All participants scored above 24 on the mini-mental state examination (MMSE). The cutoff point for mild cognitive impairment (MCI) was 26 in the Montreal Cognitive Assessment (MoCA). Participants were asked to walk at their preferred pace on a 5-m walkway with an obstacle placed in the middle of the path. The stride length, stride duration, speed and step width were measured to examine obstacle-crossing performance. Cognitive functions were assessed by MMSE and MoCA, Digit span test (DST), verbal fluent test (VFT), and visuospatial part of Rey–Osterrieth complex figure (ROCF). Timed Up and Go (TUG) test was used to assess motor function. All measures were carried out during the ‘ON’ state.

Results: Among all participants, 15 were in the PD-MCI group and 19 in the PD group. There were significant differences between groups in all cognitive functions. Significant differences in obstacle crossing performance were observed between groups in stride length and speed (p = .007-.039). Obstacle crossing performance was significantly correlated with global cognitive function (p = .000-.023). Specifically, DST indicated a significant correlation with stride length and leading leg speed (p = .027-.039). VFT significantly correlated with stride length (p = .027-.029).

Conclusion: Our results showed participants with PD-MCI demonstrated slower obstacle-crossing speed with shorter stride lengths compared to PD participants without MCI. Cognitive function, especially attention and executive function, were related to obstacle crossing performance. Taken together, future studies for PD patients are suggested to consider cognitive function for obstacle-crossing ability.

References: Stolze, H., et al., Falls in frequent neurological diseases–prevalence, risk factors and aetiology. J Neurol, 2004. 251(1): p. 79-84.
Galna, B., A.T. Murphy, and M.E. Morris, Obstacle crossing in people with Parkinson’s disease: foot clearance and spatiotemporal deficits. Hum Mov Sci, 2010. 29(5): p. 843-52.
Stegemöller, E.L., et al., Postural instability and gait impairment during obstacle crossing in Parkinson’s disease. Arch Phys Med Rehabil, 2012. 93(4): p. 703-9.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/influence-of-cognitive-function-on-obstacle-crossing-performance-in-people-with-parkinsons-disease-a-cross-sectional-study/