Prioritizing gait in dual-task conditions in people with Parkinson’s

This controlled study examined the effects of a gait prioritization strategy on walking in people with Parkinson’s disease (PD). Participants in the training group (n = 6) received 30-min therapy to prioritize their attention to take big steps while performing serial three subtractions. Participants in the control group (n = 6) received no therapy. Stride length, gait velocity, and accurate enumeration rate were measured at baseline, immediately after training and 30 min after training under both single-task (walk only or subtract only) and dual-task (walk and subtract) conditions. Performance was also assessed during therapy for the training group. Stride length and gait velocity increased immediately when participants followed instructions to prioritize their attention to take big steps (p = .005, p = .04). Further, the gait variables increased for both single and dual-task conditions for at least 30 min after training when compared to the controls; with a simultaneous reduction in the magnitude of dual-task interference (p = .03, p = .03). No difference in the accurate enumeration rate was found at any of the assessment time points. Therefore, prioritizing attention to take big steps can be an effective strategy to increase the stride length and walking speed in some people with PD.