Assessing the impact of dual-task reactive step practice in people with Parkinson's disease: A feasibility study

Andrew S. Monaghan, James M. Finley, Shyamal H. Mehta, Daniel S. Peterson

Research output: Contribution to journalArticlepeer-review


Reactive stepping is impaired in people with Parkinson's Disease (PD) but can be improved with training. However, it is unclear if reactive steps can be improved when performing a concurrent cognitive task, a common and fall-relevant circumstance. We assessed the feasibility and preliminary effectiveness of dual-task reactive step training. Specifically, we measured whether stepping and cognitive reaction time are improved after one day of dual-task reactive step practice and if improvements are retained 24 h later. Sixteen people with PD and 13 age-matched healthy controls (HC) underwent repeated from-stance support surface perturbations that elicited a reactive step while performing an auditory Stroop task. Participants returned the following day to reassess dual-task reactive stepping performance. Cognitive, neuromuscular, and stepping outcomes were calculated. Increased step lengths were observed for both groups after practice (p < 0.001). Cognitive reaction times also improved through practice; however, this was more pronounced in the HC group (group by time interaction- p < 0.001). No changes were observed for step latency, margin of stability, or EMG onset through practice. Step length and cognitive reaction time improvements were retained 24 h after practice in both groups (step length: p < 0.001; cognitive reaction time: p = 0.05). This study provides preliminary evidence for the effectiveness of dual-task reactive step training to improve step length in people with PD. The improvements in step length without compromising cognitive reaction times suggest that participants improved reactive stepping without a robust attention shift toward the postural task. Future research is necessary to determine optimal training protocols and determine if such training protocols impact falls in PD patients.

Original languageEnglish (US)
Article number102876
JournalHuman Movement Science
StatePublished - Dec 2021


  • Automatic postural responses
  • Dual-tasking
  • Falls
  • Parkinson's disease
  • Protective stepping

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Experimental and Cognitive Psychology


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