Abstract
Background: People with Parkinson's disease (PD) display poorer gait performance when walking under complex conditions than under simple conditions. Screening tests that evaluate gait performance changes under complex walking conditions may be valuable tools for early intervention, especially if allowing for massive data collection.Objectives: To investigate the use of the Goalkeeper Game (GG) to predict impairment in gait performance under complex conditions in people with Parkinson's disease (PPD) and compare its predictive power with the one of the Montreal Cognitive Assessment (MoCA) test.Methods: 74 PPD (HY stages: 23 in stage 1; 31 in stage 2; 20 in stage 3), without dementia (MoCA cut-off 21), tested in ON period with dopaminergic medication were submitted to single individual cognitive/motor evaluation sessions. MoCA and GG were used to assess cognition, and the dynamic gait index (DGI) test was used to assess gait performance under complex condition. GG test resulted in 9 measures extracted via a statistical model. The predictive power of the GG measures and the MoCA score with respect to gait performance, as assessed by DGI, were compared.Results: The predictive models based on GG obtained a better score of prediction (65%) then MoCA (56%) for DGI scores (at a 50% specificity).Conclusion: GG is a novel tool for noninvasive screening that showed a superior predictive power in assessing gait performance under complex condition in people with PD than the well-established MoCa test.
Highlights
Parkinson Disease (PD) disabling is strongly related to gait impairments, decrease in independence in daily living activities and, reduction in Health-Related Quality of Life (HRQoL) (Morris et al, 2017).Classically, gait was considered a mostly automatic motor skill
Postural instability and gait disturbances were related to visuospatial function and visuospatial memory, while bradykinesia was associated with executive function in people at early stages of PD before intake of dopaminergic medication (Domellöf et al, 2011)
Montreal Cognitive Assessment (MoCA), γ 1, t1, and t3 are moderately correlated with Dynamic Gait Index (DGI)
Summary
Parkinson Disease (PD) disabling is strongly related to gait impairments, decrease in independence in daily living activities and, reduction in Health-Related Quality of Life (HRQoL) (Morris et al, 2017).Classically, gait was considered a mostly automatic motor skill. Gait performance is strongly affected by the overlap between motor and cognitive impairments due to dysfunction of both dopaminergic and cholinergic pathways in PD (Kelly et al, 2015). Postural instability and gait disturbances were related to visuospatial function and visuospatial memory, while bradykinesia was associated with executive function in people at early stages of PD before intake of dopaminergic medication (Domellöf et al, 2011). Gait predicted decline in specific cognitive domains (fluctuating attention and visual memory) in early PD, which was selective to discrete gait characteristic (Morris et al, 2017). People with Parkinson’s disease (PD) display poorer gait performance when walking under complex conditions than under simple conditions. Screening tests that evaluate gait performance changes under complex walking conditions may be valuable tools for early intervention, especially if allowing for massive data collection
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