Objective: to evaluate disease related and cognitive features involved in motor skills of walking in people with Parkinson’s disease (PWP).

Background: curved path walking and negotiating turns may be difficult for PWP. Figure-8-Walk Test (F8WT) has been shown to be a valid indicator of the motor skill of walking in PWP. Executive functions and attention are involved in gait performance and may be altered in PWP.

Method: in this observational retrospective study, we evaluated the records of non-demented PWP attending an intensive 4 weeks cognitive-motor rehabilitative program.  As for routine practice, neurological (UPDRS; H&Y stage, Dopamine replacement therapy were recorded), a physiotherapy (F8WT; 6 minutes walking test; TUG scale) and a neuropsychological (MMSE, FAB, MoCA, WCST, TMT, Stroop test, RAVLT were administered) examinations were conducted in the best on patients’ conditions. Neurological and functional assessments were performed at the beginning and at the end of the rehabilitation period. We conducted a regression analysis to evaluate which demographic, clinical and cognitive variables were more associated with F8WT performance and with its improvement after rehabilitation.

Results: 64 patients were enrolled (M/F: 36/28; age:66.5±7.8 yrs ; disease duration 9.7±4.7yrs, LEDDS 627.7±335.5). UPDRS scale part III (18.97±3.4 vs 13.21±2.8) and physiotherapy measures (F8WT: time 12.6 vs 10.1, steps: 20.7 vs 17.1; 6MWT: 359 vs 419; TUG: 11.5 vs 8.4) significantly improved after training. Regression analysis showed that some clinical variables (age, disease duration and UPDR III) and cognitive tests (TMT part B-A and Stroop test) were associated to F8WT performance and improvement.

Conclusion: besides predictable clinical variables, cognitive abilities such as attentional set shifting and inhibitory control are implicated in motor skills of walking. F8WT is sensitive to these cognitive functions and it could be useful to take this information into account in order to better focus the cognitive motor rehabilitation programs of each patient.

References: Lowry K, Woods T, Malone A, Krajek A, Smiley A, Van Swearingen J. The Figure-of-8 Walk Test used to detect the loss of motor skill in walking among persons with Parkinson’s disease. Physiother Theory Pract. 2020 Jun 16:1-9. doi: 10.1080/09593985.2020.1774948. Yogev-Seligmann G, Hausdorff JM, Giladi N. The role of executive function and attention in gait. Mov Disord. 2008 Feb 15;23(3):329-42; quiz 472. doi: 10.1002/mds.21720.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/motor-skills-of-walking-in-parkinsons-disease-towards-a-better-understanding-of-the-cognitive-abilities-implicated-in-f8wt/