Neurological Sciences

, Volume 39, Issue 12, pp 2151–2157 | Cite as

Which cognitive dual-task walking causes most interference on the Timed Up and Go test in Parkinson’s disease: a controlled study

  • E. Zirek
  • Burcu Ersoz HuseyinsinogluEmail author
  • Z. Tufekcioglu
  • B. Bilgic
  • H. Hanagasi
Original Article



There is evidence that cognitive load has a negative effect on the gait of patients with Parkinson’s disease (PD). However, it is not clear which type of cognitive activities are more likely to affect dual-task abilities in this patient group.


To compare the cognitive dual-task abilities in patients with PD and control subjects and to analyze the effect of different cognitive activities on the walking ability of patients with PD.


The Hoehn and Yahr scale, the Freezing of Gait Questionnaire (FOGQ), Montreal Cognitive Assessment (MoCA), and the Functional Reach Test were used to include and exclude the patients. The Timed Up and Go (TUG) test was applied under single and dual-task conditions.


The completion time of TUG was found to be increased in the PD group compared with the healthy controls under single- and dual-task conditions (p < 0.05). The completion time of TUG was significantly increased in dual-task conditions with complex attention activity (serial subtractions test) compared with other dual-task conditions in patients with PD (p < 0.001).


The gait performance of both healthy subjects and patients with PD was impaired with cognitive activity during walking, and patients with PD showed more impairment under different cognitive dual tasks. Among the other cognitive tasks, the ‘serial sevens’ test, a measure of complex attention, significantly increased the completion time of TUG.


While assessing the dual-task ability of patients with early-stage PD, tasks that increase the demand for complex attention seem to be more sensitive to showing impaired dual-task ability.


Parkinson’s disease Dual-task Gait Error Balance 



This work was supported by Scientific Research Projects Coordination Unit of Istanbul University. Project Number: TYL-2016-20130.

Compliance with ethical standards

The study was approved by the Istanbul Medipol University  Non-Invasive Clinical Research Ethics Committee, (Protocol Number: 646). All participants were informed about the procedure and gave informed consent. The research also followed the STROBE statement.

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

All procedures performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Physical Therapy and Rehabilitation, Faculty of Health SciencesBingol UniversityBingolTurkey
  2. 2.Department of Neurological Physiotherapy and Rehabilitation, Division of Physiotherapy and Rehabilitation, Faculty of Health SciencesIstanbul University-CerrahpasaIstanbulTurkey
  3. 3.Behavioural Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of MedicineIstanbul UniversityIstanbulTurkey

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