How to prevent cognitive overload in the walking-arithmetic dual task among patients with Parkinson's disease.

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BackgroundParticipants with Parkinson's disease (PD) may experience difficulty during certain dual-task (DT) tests. Thus, it is necessary to keep the cognitive load within the limits of their ability.ObjectiveTo identify cognitive overload and its influence on the walking and auditory addition and subtraction (AAS, all values within the range of 0-20) DT performance of patients with PD.Study designA cross-sectional observational study with convenience sampling.SettingOutpatient clinic of the Department of Neurology.SubjectsSixteen patients with PD and 15 sex- and age- matched people elderly healthy controls (HCs).MethodsVerbal calculation responses and gait parameters were collected from the two groups in the 2-min single arithmetic task (2-min SAT), 2-min single walking task (2-min SWT), and 2-min walking-arithmetic dual task (2-min WADT).ResultsThe group differences in the lower-limb gait parameters increased in the 2-min WADT (P  0.05). In the 2-min SAT, the calculation speed of the PD group was significantly lower than that of the HC group (P ConclusionsCognitive overload was observed in patients with PD. This was mainly reflected in the failure of gait control and accurate calculation, indicated by gait parameters of the lower limbs and accuracy of calculation. To impose a constant cognitive load, the amount added or subtracted, especially in subtraction with borrowing, should not be mixed during a sequential arithmetic problem in the DT, and equations with the value of the first operand equal to 20 or approximately 13, the value of the second operand approximately 7, or the value of the third operand of approximately 9 should be excluded in the AAS DT.Trial registrationClinical trial registration number: ChiCTR1800020158.

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