Objective: To explore the concordance between perceived difficulty and focus, to actual performance during a dual-task (DT) two-minute walk test (2MWT) in people with Parkinson’s disease (PD).

Background: Over the last decades, many studies have explored DT walking in PD. Dual-task interference (DTI) has been calculated to make claims as to whether one task is being prioritized over another (e.g., posture first or posture second). It is unclear whether there is a concordance between perceptions of dual-task difficulty and focus, and actual performance. Understanding this concordance, or lack thereof, is an important step in validating the concept of prioritization.

Method: This cross-sectional study used baseline data from the Supported home Training in Everyday life for Parkinson’s diseaSe (STEPS) trial. Participants performed a 2MWT with and without a cognitive DT and thereafter rated perceived DT difficulty and focus. Performance (gait speed, reaction time (RT), and accuracy) measures (absolute, DTI and prioritization) were compared across groups with different perceptions of difficulty and focus using one-way between group ANOVA with post-hoc tests.

Results: A total of 125 people with PD (mean age 69.4 years, women n=63) were included. All three groups (people who agreed (n=62), disagreed (n=38), or neither agreed nor disagreed (n=25) to the statement that dual-tasking was difficult) walked slower during DT compared to single task (mean difference 0.06-0.11 m/s). Those who disagreed that dual-tasking was difficult had a higher DTI on gait speed than those who found it difficult (p=0.015), and a higher DTI on RT than those who had responded neither (p=0.021). Both the group that stated having focused on the cognitive task (n=64), and those who perceived they had focused on both tasks equally (n=54), had a calculated cognitive task prioritization. The group who stated having focused on walking (n=6) did not have a significant calculated task prioritization.

Conclusion: The findings showed a lack of concordance between perceived difficulty and actual performance. People who perceived dual-tasking as not being difficult had the highest DTI on both gait speed and cognitive RT. Further, there was concordance between calculated and perceived prioritization among people who perceived having prioritized the cognitive task, but a lack of concordance among those who perceived having prioritized walking or both tasks equally.

« Back to 2025 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/perceived-versus-actual-performance-during-dual-task-walking-insights-from-parkinsons-disease/