Introduction

Impaired gait is observed in patients with Parkinson’s disease (PD) in both single-task (ST) and dual-task (DT) conditions. Non-motor symptoms (NMSs), another vital symptom future experienced along the PD disease trajectory, contribute to gait performance in PD. However, whether DT gait performance is indicative of NMS burden (NMSB) remains unknown. This study investigated correlation between NMS and DT gait performance and whether NMSB is reflected in the DT effects (DTEs) of gait parameters in PD.

Methods

Thirty-three idiopathic PD participants were enrolled in this study; the median H-Y staging was 2.5. NMSB was assessed by Non-motor Symptoms Scale (NMSS). Spatiotemporal gait parameters under ST and DT conditions were evaluated by wearable sensors. Gait parameters under ST and DT conditions and DTEs of gait parameters were compared across NMSB groups. The associations between NMS and DTEs of gait parameters were analyzed by correlation analysis and linear regression models.

Results

Compared to PD patients with mild-moderate NMSB, the severe-very severe NMSB group showed slower gait speed and shorter stride length under both ST and DT conditions (p < 0.05). DT had significantly negative effect on gait parameters in PD patients, including gait speed, stride length, and gait cycle duration (p < 0.05). PD patients with mild-moderate NMSB showed larger DTEs of cadence and bilateral gait cycle duration (p < 0.05). DTEs of bilateral gait cycle duration and swing phase on the more affected (MA) side were significantly correlated with NMSS scores (∣rSp∣ ≥ 0.3, p < 0.05). Gait cycle duration on the less affected (LA) side explained 43% of the variance in NMSS scores, when accounting for demographic and clinical confounders (β = − 1.095 95% CI − 4.061 ~ − 0.058, p = 0.044; adjusted R² = 0.434).

Conclusion

DT gait performance could reflect NMSB in PD patients at early stage, and gait cycle duration is a valuable gait parameter to further investigate and to provide more evidence for PD management.

中文翻译：

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帕金森病双重任务条件下的步态表现和非运动症状负担

介绍

在单任务 (ST) 和双任务 (DT) 条件下，帕金森病 (PD) 患者均观察到步态受损。非运动症状 (NMS) 是 PD 疾病轨迹中未来经历的另一种重要症状，有助于 PD 的步态表现。然而，DT 步态性能是否指示 NMS 负担 (NMSB) 仍然未知。本研究调查了 NMS 和 DT 步态性能之间的相关性，以及 NMSB 是否反映在 PD 步态参数的 DT 效应 (DTE) 中。

方法

33 名特发性 PD 参与者参加了这项研究；HY 分期中位数为 2.5。NMSB 通过非运动症状量表 (NMSS) 进行评估。ST 和 DT 条件下的时空步态参数由可穿戴传感器评估。比较了 NMSB 组在 ST 和 DT 条件下的步态参数和步态参数的 DTE。通过相关分析和线性回归模型分析步态参数的 NMS 和 DTE 之间的关联。

结果

与轻-中度 NMSB 的 PD 患者相比，重度-极重度 NMSB 组在 ST 和 DT 条件下均表现出较慢的步态速度和较短的步幅（p  < 0.05）。DT 对 PD 患者的步态参数有显着的负面影响，包括步速、步幅和步态周期持续时间（p  < 0.05）。具有轻度-中度 NMSB 的 PD 患者表现出较大的节奏和双侧步态周期持续时间的 DTE ( p  < 0.05)。双侧步态周期持续时间和受影响较大 (MA) 侧的摆动期的 DTE 与 NMSS 评分显着相关 (|rSp| ≥ 0.3, p < 0.05)。在考虑人口统计学和临床​​混杂因素时，受影响较小 (LA) 侧的步态周期持续时间解释了 NMSS 评分中 43% 的差异（β  = − 1.095 95% CI − 4.061 ~ − 0.058，p  = 0.044；调整后的R ²  = 0.434）。

结论

DT 步态表现可以反映早期 PD 患者的 NMSB，步态周期持续时间是一个有价值的步态参数，可以进一步研究并为 PD 管理提供更多证据。