Dual Tasks Affect Walking Performance in Parkinson Disease

In patients with Parkinson disease (PD), dual tasks are associated with walking performance, according to study results published in Parkinsonism and Related Disorders.

Electronic databases were searched for studies that investigated the effects of dual tasks on walking in PD. A total of 19 studies that compared gait speed in single- and dual-task over ground walking conditions in 510 participants were included in the final analysis. In the meta-analysis, researchers investigated the impact of baseline physical function on dual-task gait performance. Single-task gait speed defined baseline mobility in each study. The studies were categorized according to the type of cognitive task; the 4 identified primary concurrent task types were arithmetic (7 comparisons), language (8 comparisons), memory (7 comparisons), and motor (6 comparisons).

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The pooled analysis, which compared 28 different outcome measures of single-task and dual-task gait speed, found a moderate to large standardized mean difference (SMD) effect (SMD, −0.68; standard error [SE],0.05; 95% CI, −0.78 to −0.58; P <.0001). Differences were found between single and dual-task gait performance in studies that included patients with PD with a mean single-task gait speed ≥1.1 m/s (SMD, −0.78; SE, 0.09; 95% CI, −0.96 to −0.60; P <.0001) and a mean single-task gait speed <1.1 m/s (SMD, −0.65; SE, 0.06; 95% CI, −0.77 to −0.53; P <.0001). Each cognitive dual task domain also adversely affected gait performance: arithmetic (SMD, −0.78; SE, 0.09; 95% CI, −0.95 to −0.60; P <.0001); language (SMD, −0.76; SE, 0.09; 95% CI, −0.94 to −0.58; P <.0001); memory (SMD, −0.49; SE, 0.07; 95% CI, −0.63 to −0.34; P <.0001); and motor (SMD, −0.78; SE, 0.12; 95% CI, −1.02 to −0.54; P <.0001).

A limitation of the analysis included the lack of studies that featured a comparative control.

“Overall, the findings provide new evidence on the effects of dual-task studies and PD walking speed,” the researchers wrote. “In each study, persons with PD walked slower during dual tasks regardless of mean single task gait speed or the type of concurrent task.”


Raffegeau TE, Krehbiel LM, Kang N, et al. A meta-analysis: Parkinson’s disease and dual-task walking [published online December 12, 2018]. Parkinsonism Relat Disord. doi:10.1016/j.parkreldis.2018.12.012