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Affiliation
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School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: rcyhuang@ntu.edu.tw. |
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Abstract
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OBJECTIVE: To investigate the effect of task prioritization on dual-task control in Parkinson disease (PD) associated with different postural impairments.
DESIGN: Cross-sectional study. Participants were instructed to keep two interlocking rings apart and maintain balance in a tandem stance. Attention was focused on either stance stability (posture-focus strategy) or the interlocking rings (supraposture-focus strategy). SETTING: University research laboratory. PARTICIPANTS: 15 patients with PD and less postural impairment, and 15 patients with PD and more postural impairment. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUREMENTS: Postural sway, postural determinism (%DET), ankle co-contraction, and ring-touching time.
RESULTS: In the less-impairment group, the supraposture-focus strategy provided smaller postural sway and postural %DET compared to the posture-focus strategy. In the more-impairment group, task prioritization showed less effects on both postural sway and postural %DET. The supraposture-focus strategy led to less ankle co-contraction than the posture-focus strategy in the more-impairment group, but task prioritization did not affect ankle co-contraction in the less-impairment group. In both groups, the supraposture-focus strategy led to less ring-touching time than the posture-focus strategy.
CONCLUSIONS: The supraposture-focus strategy provided better dual-task control than the posture-focus strategy in both PD groups. In the less-impairment group, the supraposture-focus strategy enhanced postural automaticity and postural stability. In the more-impairment group, the supraposture-focus strategy reduced ankle stiffness, due to reduced muscle co-contraction.
Copyright © 2020. Published by Elsevier Inc.
Language: en |