Abstract
Background Dual-task (DT) training is gaining ground as a physical therapy intervention in people with Parkinson disease (PD). Future studies evaluating the effect of such interventions need reliable outcome measures. To date, the test-retest reliability of DT measures in patients with PD remains largely unknown.
Objective The purpose of this study was to assess the reliability of DT outcome measures in patients with PD.
Design A repeated-measures design was used.
Methods Patients with PD (“on” medication, Mini-Mental State Examination score ≥24) performed 2 cognitive tasks (ie, backward digit span task and auditory Stroop task) and 1 functional task (ie, mobile phone task) in combination with walking. Tasks were assessed at 2 time points (same hour) with an interval of 6 weeks. Test-retest reliability was assessed for gait while performing each secondary task (DT gait) for both cognitive tasks while walking (DT cognitive) and for the functional task while walking (DT functional).
Results Sixty-two patients with PD (age=39–89 years, Hoehn and Yahr stages II–III) were included in the study. Intraclass correlation coefficients (ICCs) showed excellent reliability for DT gait measures, ranging between .86 and .95 when combined with the digit span task, between .86 and .95 when combined with the auditory Stroop task, and between .72 and .90 when combined with the mobile phone task. The standard error of measurements for DT gait speed varied between 0.06 and 0.08 m/s, leading to minimal detectable changes between 0.16 and 0.22 m/s. With regard to DT cognitive measures, reaction times showed good-to-excellent reliability (digit span task: ICC=.75; auditory Stroop task: ICC=.82).
Limitations The results cannot be generalized to patients with advanced disease or to other DT measures.
Conclusions In people with PD, DT measures proved to be reliable for use in clinical studies and look promising for use in clinical practice to assess improvements after DT training. Large effects, however, are needed to obtain meaningful effect sizes.
Footnotes
Dr Keus and Professor Nieuwboer provided concept/idea/research design. Dr Strouwen and Professor Nieuwboer undertook the writing. Dr Strouwen, Mrs Molenaar, Dr Keus, Mrs Münks, and Professor Bloem were responsible for data collection. Dr Strouwen and Professor Nieuwboer performed data analysis. Professor Nieuwboer, Mrs Molenaar, Dr Keus, and Professor Bloem provided project management. Mrs Molenaar, Mrs Münks, Dr Keus, and Professor Bloem provided consultation (including review of manuscript before submission). The authors thank all patients who participated in the study.
Ethical approval for the study was obtained (CME KU Leuven–B322201213165/S53419).
This work was funded by the Jacques and Gloria Gossweiler Foundation.
The DUALITY trial was registered on ClinicalTrials.gov (NCT01375413).
- Received May 19, 2015.
- Accepted January 25, 2016.
- © 2016 American Physical Therapy Association
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