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Background <p>Mobility, cognitive processing, and balance confidence impairments can negatively affect functional mobility in people with Parkinson’s disease (PD). This study aimed to examine the effects of a cognitive dual-task on functional mobility during Timed Up and Go (TUG) sub-phases involving transitions and turns. A secondary aim was to explore whether balance confidence was associated with dual-task interference (DTI) on TUG total duration and sub-phases.</p> Methods <p>A cross-sectional design was employed. Participants completed TUG and TUG-COG (serial three subtractions) and inertial sensors recorded spatiotemporal data on transitions and turns. Paired samples t-tests and corresponding effect sizes (Cohen’s d) were used to compare TUG conditions. Multivariate linear regression assessed the association between balance confidence and DTI on total duration and sub-phases, controlling for gait speed and executive function.</p> Results <p>People with mild-to-moderate PD (N = 94, mean age: 68.7&#xa0;years) completed TUG-COG 2.7&#xa0;s slower than TUG (p &lt; 0.001, d = 0.5, DTI = 22.9%). The cognitive task led to reduced performance across TUG sub-phases, with generally stronger effects observed in turning outcomes (d = 0.25–0.45) and comparatively smaller effects observed in postural transitions <b>(</b>d = 0.02–0.38<b>).</b> Balance confidence explained variance in DTI for sit-to-stand duration (B = -−3.560, 95% CI [−5.499, −1.622], p &lt; 0.001), whereas no effect was observed for other sub-phases.</p> Conclusion <p>Dual-tasking impaired nearly all components of the TUG, prolonging total duration and altering spatiotemporal characteristics of transitions and turns. Turning was more strongly impacted by dual-tasking than postural transitions, which has relevance for fall-prevention strategies. Together, the results of this study indicate that clinicians should prioritize turning during dual-task gait training and incorporate assessment of balance confidence to better capture functional capacity in transitional movements such as sit-to-stand.</p>

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Impact of dual-tasking and balance confidence on turns and transitions: a cross-sectional study in Parkinson’s disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月13日

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  • Hanna Johansson,
  • Niklas Löfgren,
  • Franchino Porciuncula,
  • Breiffni Leavy

摘要

Background

Mobility, cognitive processing, and balance confidence impairments can negatively affect functional mobility in people with Parkinson’s disease (PD). This study aimed to examine the effects of a cognitive dual-task on functional mobility during Timed Up and Go (TUG) sub-phases involving transitions and turns. A secondary aim was to explore whether balance confidence was associated with dual-task interference (DTI) on TUG total duration and sub-phases.

Methods

A cross-sectional design was employed. Participants completed TUG and TUG-COG (serial three subtractions) and inertial sensors recorded spatiotemporal data on transitions and turns. Paired samples t-tests and corresponding effect sizes (Cohen’s d) were used to compare TUG conditions. Multivariate linear regression assessed the association between balance confidence and DTI on total duration and sub-phases, controlling for gait speed and executive function.

Results

People with mild-to-moderate PD (N = 94, mean age: 68.7 years) completed TUG-COG 2.7 s slower than TUG (p < 0.001, d = 0.5, DTI = 22.9%). The cognitive task led to reduced performance across TUG sub-phases, with generally stronger effects observed in turning outcomes (d = 0.25–0.45) and comparatively smaller effects observed in postural transitions (d = 0.02–0.38). Balance confidence explained variance in DTI for sit-to-stand duration (B = -−3.560, 95% CI [−5.499, −1.622], p < 0.001), whereas no effect was observed for other sub-phases.

Conclusion

Dual-tasking impaired nearly all components of the TUG, prolonging total duration and altering spatiotemporal characteristics of transitions and turns. Turning was more strongly impacted by dual-tasking than postural transitions, which has relevance for fall-prevention strategies. Together, the results of this study indicate that clinicians should prioritize turning during dual-task gait training and incorporate assessment of balance confidence to better capture functional capacity in transitional movements such as sit-to-stand.