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Motor and cognitive interference on multitask walking deficits in people with Parkinson disease
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Introdução: A Doença de Parkinson (PD) e o Defeito cognitivo ligeiro na PD (PDMCI) conduzem a alterações na marcha e ao aumento do risco de queda, particularmente em condições de dupla-tarefa (cognitiva e motora) e multitarefa. No entanto, a influência negativa sobre a marcha da realização de tarefas cognitivas e motoras concorrentes e a contribuição adicional do defeito cognitivo ligeiro ainda não são claros. Objectivos: Investigar a influência da dupla-tarefa (motora e cognitiva) e da multitarefa no tempo de execução do teste Timed “Up & Go” (TUG) e o impacto que o PD-MCI apresenta nesta interferência. Métodos: Foi realizado um estudo transversal, envolvendo 3 grupos: MCI+PD (participantes com PD-MCI, n=9), MCI-PD (participantes sem PD-MCI, n=10) e controlos com a mesma idade (n=10). Os participantes com PD foram avaliados no estado ON da medicação, através de uma bateria de testes cognitivos e a sua performance na marcha através dos testes: TUG- tarefa simples, TUG-dupla tarefa (TUGcog e TUGman) e TUG multitarefa (TUGmulti). Resultados: Os participantes foram semelhantes ao nível das características demográficas, clínicas e de equilíbrio excepto no UPDRS I e II. A avaliação cognitiva mostrou diferenças estatisticamente significativas entre os grupos com PD nos domínios da atenção e memória de trabalho, funções executivas e memória. A realização da tarefa cognitiva (TUGcog) mostrou diferenças estatisticamente significativas entre os grupos MCI+PD e MCI-PD (p=0.022), mas não com o TUGman e o TUGmulti (p>0.05). A interferência no TUG mostrou diferenças estatisticamente significativas entre os grupos MCI-PD e MCI+PD com as interferências cognitivas (p=0.004) e da multitarefa (p=0.041) mas não com a interferência motora (p=0.935). Conclusão: Em idosos com PD o TUG parece ser mais afectado pela realização simultânea de tarefas que envolvam recursos cognitivos (TUGcog e TUGmulti) e o PD-MCI parece ter um efeito negativo adicional nesta interferência.
Introduction: Parkinson´s Disease (PD) and Mild cognitive impairment in PD (PDMCI) lead to gait changes and increase risk of falls, particularly under dual-task (cognitive and motor) and multitasking conditions. However, the negative influence of performing motor and cognitive concurrent tasks and the additional contribution of mild cognitive impairment are still unclear. Objectives: To investigate the influence of the dual-task (motor and cognitive) and multitasking in the execution time of Timed Up & Go test (TUG) and the impact that the PD-MCI presents in this interference. Methods: A cross-sectional study was conducted evolving three groups: MCI+PD (participants with PD-MCI, n=9), MCI-PD (participants without PD-MCI, n=10) and aged matched controls (n=10). Participants were evaluated in ON medication state in order to assessed participants characteristics, cognitive functions and walking performance through Timed “Up & Go” Test (TUG) simple task, TUG-dual task (TUGcog and TUGman) and TUG multitask (TUGmulti). Results: Participants were similar in demographic, clinical and balance characteristics except in UPDRS I and II. Cognitive evaluation showed statistically significant differences between MCI+PD and MCI-PD groups in domains of attention and working memory, executive functions and memory. TUG simple task performance was similar between 3 groups (p>0.05). TUGcog showed statistically significant differences between MCI+PD and MCI-PD groups (p=0.022). On TUGman and TUGmulti no statistically significant differences were found between groups with PD (p>0.05). The interference in TUG showed statistically significant differences between MCI-PD and MCI+PD groups with cognitive (p=0.004) and multitask (p=0.041) interferences but no with motor interference (p=0.935). Conclusion: In the elderly with PD the TUG seems to be more affected by the simultaneous accomplishment of tasks that involve cognitive resources (TUGcog and TUGmulti) and the PD-MCI seems to have an additional negative effect in this interference.
Introduction: Parkinson´s Disease (PD) and Mild cognitive impairment in PD (PDMCI) lead to gait changes and increase risk of falls, particularly under dual-task (cognitive and motor) and multitasking conditions. However, the negative influence of performing motor and cognitive concurrent tasks and the additional contribution of mild cognitive impairment are still unclear. Objectives: To investigate the influence of the dual-task (motor and cognitive) and multitasking in the execution time of Timed Up & Go test (TUG) and the impact that the PD-MCI presents in this interference. Methods: A cross-sectional study was conducted evolving three groups: MCI+PD (participants with PD-MCI, n=9), MCI-PD (participants without PD-MCI, n=10) and aged matched controls (n=10). Participants were evaluated in ON medication state in order to assessed participants characteristics, cognitive functions and walking performance through Timed “Up & Go” Test (TUG) simple task, TUG-dual task (TUGcog and TUGman) and TUG multitask (TUGmulti). Results: Participants were similar in demographic, clinical and balance characteristics except in UPDRS I and II. Cognitive evaluation showed statistically significant differences between MCI+PD and MCI-PD groups in domains of attention and working memory, executive functions and memory. TUG simple task performance was similar between 3 groups (p>0.05). TUGcog showed statistically significant differences between MCI+PD and MCI-PD groups (p=0.022). On TUGman and TUGmulti no statistically significant differences were found between groups with PD (p>0.05). The interference in TUG showed statistically significant differences between MCI-PD and MCI+PD groups with cognitive (p=0.004) and multitask (p=0.041) interferences but no with motor interference (p=0.935). Conclusion: In the elderly with PD the TUG seems to be more affected by the simultaneous accomplishment of tasks that involve cognitive resources (TUGcog and TUGmulti) and the PD-MCI seems to have an additional negative effect in this interference.
Descrição
Tese de mestrado, Neurociências, Universidade de Lisboa, Faculdade de Medicina, 2017
Palavras-chave
Doença de Parkinson Defeito cognitivo ligeiro na Doença de Parkinson Risco de queda Dupla-tarefa Multitarefa Teste Timed “Up & Go” Teses de mestrado - 2017