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Visual exploration during gait in Parkinson's disease and association with cognitive characteristics

Stuart, S.G., King, H., Galna, B.ORCID: 0000-0002-5890-1894, Godfrey, A., Lord, S. and Rochester, L. (2015) Visual exploration during gait in Parkinson's disease and association with cognitive characteristics. In: 19th International Congress of Parkinson's Disease and Movement Disorders, 14-18 June 2015, San Diego, CA, USA.



Objective: To understand visual exploration during gait in Parkinson's disease (PD) and potential contributing factors such as cognition. To address this we studied 1) real-time visual exploration during gait in PD in response to environmental and attentional load; and 2) the association of visual exploration during gait with cognitive characteristics.

Background: Visual exploration is important during real-world gait for accurate navigation and attenuation to environmental risk factors. Visual information gathered through exploration is processed and mediated by cognitive mechanisms, however visual and cognitive deficits are common in PD and may contribute to gait dysfunction and falls.

Methods: 20 PD participants and 20 age-matched controls walked under different environmental load (straight walking, walking through a door and turning), during single and dual-task (attentional load). Real-time visual exploration (saccade frequency) during gait was measured using a Dikablis mobile eye-tracker. Participants underwent visual, cognitive (global cognition, attention, visuo-spatial ability, executive function) and clinical assessments. The effect of environment and dual-task was assessed using a mixed model ANOVA. The association between cognition and saccadic frequency within each group was assessed using Spearman's rho correlations.

Results: PD participants took longer to complete all tasks (p = .015) and made less frequent saccades (p = .009). For both groups, saccade frequency significantly increased with environmental complexity (p < .001) and reduced during dual-task (p < .001). Poorer cognition and attention were associated with increased saccade frequency during several of the walking tasks for PD but not for control participants. These included turning during single-task (rho = -0.53, p = .021) and straight-line single-task walking (rho = 0.67, p = .003).

Conclusions: PD explore their environment less than controls despite walking slower but alter their visual exploration in the same as controls in response to environmental and attentional demands. Visual exploration during gait is associated with cognitive characteristics in PD which may underpin exploration impairment, and may contribute to gait deficit and falls risk. Further work is required to understand the underlying cognitive mechanisms involved in visual exploration during gait in PD.

Item Type: Conference Item
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Other Information: Part of: Movement Disorders (2015), Volume: 30, Issue: Suppl 1, S350, ISSN: 1531-8257.
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