Objective: The goal of the study was to explore speech and gait performance trade-off when individuals with Parkinson’s disease (PD) engaged in concurrent speaking and walking tasks.

Background: Speech impairments, such as reduced loudness, imprecise articulation, and breathy hoarse voice frequently develop in PD, in addition to common gait disorders and balance deficits. Walking and talking simultaneously, that was once effortless, is disrupted in PD, and yet, little is known about how attention is distributed between the two domains.

Method: Forty-seven participants (36 PD and 11 controls) completed a dual task (DT) paradigm of producing speech monologues along with a simple gait of straight-line walking and a complex gait of turning and avoiding obstacles. Speech intensity in sound pressure level (SPL in dB) and fundamental frequency (F0 in Hz) were obtained from the acoustic recordings. Gait characteristics, including gait velocity (cm/sec), mean stride length (cm), and enhanced gait variability index (eGVI), were extracted from the temporal spatial gait data. Dual task effect (DTE) and the modified Attention Allocation Index (mAAI) were computed for each speech and gait variable. Multilevel linear regression models were performed to analyze the effect of dual tasking on speech and gait measures.

Results: Both groups increased speech intensity (p <0.001) and F0 (p <0.001) in DT conditions with no differences between simple and complex gait. Significant reductions in gait velocity (p<0.001) and stride length (p=0.027) were found in DT conditions but not for eGVI (p>0.9). The PD group exhibited further gait declines in DT complex gait condition. The mAAI analyses showed that speech DTEs were consistently greater than gait DTEs.

Conclusion: The PD group was capable of increasing intensity and F0 to a similar degree as the controls, suggesting that the mechanism of raising loudness during concurrent walking remains robust in mild-moderate PD. The mAAI revealed a consistent pattern of speech task prioritization of enhancing speech intensity and F0 while simultaneously exhibiting decreased gait velocity and stride length in both DT conditions of simple and complex gait.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/exploring-the-trade-offs-between-speech-and-gait-in-parkinsons-disease/