Investigation of Perceived and Real-Time Dual-Task Performance Under Different Motor-Cognitive Dual-Task Combinations in Patients with Parkinson's Disease

Yıl 2025, Cilt: 12 Sayı: 2, 516 - 528, 31.08.2025

Ali Furkan Şanlı , Burcu Ersöz Hüseyinsinoğlu , Başar Bilgiç , Haşmet Ayhan Hanağası

https://doi.org/10.21020/husbfd.1672731

Öz

Objective: In individuals with Parkinson’s disease, dual-task difficulties can be assessed either through self-reported perception scales or objective performance-based tests. However, the relationship between these two evaluation methods remains unclear. The aim of this study was to examine the association between perceived and actual dual-task performance in individuals with Parkinson’s disease and to evaluate performance differences across various types of dual-task conditions.
Methods: A total of 117 participants diagnosed with idiopathic Parkinson’s disease, classified between Hoehn and Yahr stages 1 to 3, with a Mini-Mental State Examination score of at least 21 and no history of dementia, were included. Actual dual-task performance was assessed using the Timed Up and Go test with additional motor and cognitive secondary tasks, as well as the Six Spot Step Test. Perceived dual-task performance was measured using the Dual-Task Questionnaire. Statistical analyses were performed using Spearman’s correlation coefficient and the Friedman test.
Results: The mean age of the participants was 62.44 ± 10.06 years, and the average disease duration was 6.34 ± 4.69 years. A statistically significant but weak correlation was found between perceived performance and the cognitive dual-task condition of the Timed Up and Go test (r=0.214; p=0.02), as well as the motor dual-task condition (r=0.277; p=0.002). No significant relationship was observed between perceived performance and the Six Spot Step Test (r=0.165; p=0.075). Additionally, the dual-task cost in the motor condition of the Timed Up and Go test was significantly higher than that in the cognitive condition (Z= -4.4; p<0.001).
Conclusion: The weak association between perceived and real-time dual-task performance suggests that these two domains should be evaluated separately. Furthermore, the type of secondary task accompanying the walking task may lead to different outcomes in individuals’ dual-task performance. A detailed examination of these effects in patients with Parkinson’s disease could provide valuable guidance for developing more effective rehabilitation plans.

Anahtar Kelimeler

parkinson’s disease , dual-task performance , motor-cognitive interference

Parkinson Hastalarında Algılanan ve Gerçek-Zamanlı Çift-Görev Performansının Farklı Motor-Kognitif Çift-Görev Eşleşmeleri Altında İncelenmesi

Öz

Amaç: Parkinson hastalarında çift görev koşulları altında ortaya çıkan zorluklar, bireylerin öznel algılarına dayalı ölçekler ile ya da performans testleri aracılığıyla değerlendirilebilmektedir. Ancak bu iki değerlendirme yöntemi arasındaki ilişki henüz yeterince açıklığa kavuşmamıştır. Bu çalışmanın amacı, Parkinson hastalarında algılanan çift görev performansı ile gerçek zamanlı performans testleri arasındaki ilişkiyi incelemek ve farklı çift görev türlerine bağlı olarak gözlemlenen performans farklılıklarını değerlendirmekti.
Yöntem: Çalışmaya, İdiyopatik Parkinson hastalığı tanısı almış, Hoehn-Yahr evre 1 ila 3 arasında olan, Mini-Mental Durum Değerlendirme puanı en az 21 olan ve demans öyküsü bulunmayan toplam 117 birey dahil edilmiştir. Gerçek zamanlı çift görev performansı, Zamanlı Kalk Yürü Testi'ne entegre edilen motor ve bilişsel ikincil görevler ile Altı Nokta Adım Testi kullanılarak değerlendirilmiştir. Algılanan performans düzeyi ise İkili Görev Anketi ile ölçülmüştür. İstatistiksel analizlerde Spearman korelasyon katsayısı ve Friedman testi kullanılmıştır.
Bulgular: Katılımcıların yaş ortalaması 62,44 ± 10,06 yıl, hastalık süresi ortalaması ise 6,34 ± 4,69 yıldır. Algılanan performans ile Zamanlı Kalk Yürü Testi’nin bilişsel görevli versiyonu arasında (r=0,214; p=0,02) ve motor görevli versiyonu arasında (r=0,277; p=0,002) istatistiksel olarak anlamlı fakat zayıf düzeyde ilişkiler saptanmıştır. Altı Nokta Adım Testi ile algılanan performans arasında anlamlı bir ilişki gözlenmemiştir (r=0,165; p=0,075). Ayrıca, Zamanlı Kalk Yürü Testi’ne entegre edilen motor görevli koşulda gözlemlenen çift görev yükü, bilişsel görevli koşula kıyasla anlamlı düzeyde daha yüksek bulunmuştur (Z=-4,4; p<0,001).
Sonuç: Algılanan ve gerçek-zamanlı çift-görev performansı arasındaki zayıf ilişki değerlendirmede bu iki alanın ayrı ayrı gözden geçirilmesi gerektiğini göstermektedir. Ayrıca, yürüme görevine eşlik eden ikincil görevin türü bireylerin çift görev performansı üzerinde farklı sonuçlara neden olabilir. Parkinson hastalarında bu etkilerin ayrıntılı olarak incelenmesi daha etkin rehabilitasyon planı için yol gösterici olacaktır.

Anahtar Kelimeler

parkinson hastalığı , çift-görev performansı , motor-kognitif etkileşim

Etik Beyan

Araştırmamız Marmara Üniversitesi Sağlık Bilimleri Fakültesi Girişimsel Olmayan Etik Kurulu tarafından onaylandı (2025/69 protokol numaralı). Katılımcılar çalışmaya gönüllülük esasıyla katıldı ve araştırmacılar tarafından verilen aydınlatılmış onam formunu imzaladı.

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