The effect of directing attention during walking under dual-task conditions in Parkinson's disease

Abstract

The aim of this study was to investigate the effect of directing attention on walking performance under dual-task conditions in people with Parkinson's disease (PD). Twelve subjects with mild to moderate PD were tested ‘on’ medication. Subjects walked at comfortable speed under 2 baseline conditions: (i) walking with hands-free, no specific instructions and (ii) walking carrying a tray and glasses, no specific instructions; and 2 experimental conditions: (i) walking carrying a tray and glasses with instructions to direct attention towards walking and (ii) walking carrying a tray and glasses with instructions to direct attention towards the tray and glasses. When instructed to direct their attention towards walking while carrying the tray and glasses, subjects walked faster ( P=0.003) and with longer strides ( P<0.001) than when they were given no specific instructions. These improvements in walking were achieved without any significant adverse effect on carrying the tray of glasses. The improvement obtained was to a level comparable to that achieved when subjects walked with their hands-free. This suggests that specific instructions can be used to manipulate attention to enhance the performance of everyday dual-tasks in people with mild to moderate PD.