Literature DB >> 22318131

Postural instability and gait impairment during obstacle crossing in Parkinson's disease.

Elizabeth L Stegemöller1, Thomas A Buckley, Chris Pitsikoulis, Ernest Barthelemy, Ryan Roemmich, Chris J Hass.   

Abstract

OBJECTIVE: To examine whether Parkinson's disease (PD) affects gait behavior and stability while walking over an obstacle.
DESIGN: Parallel group comparisons were completed in which participants completed 5 trials of normal walking and 5 trials of obstacle crossing while gait kinematics and kinetics were collected.
SETTING: University biomechanics laboratory. PARTICIPANTS: Individuals with PD (n=10) and age- and sex-matched healthy older adults (n=10).
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Gait parameters, obstacle clearance parameters, and center of mass motion were calculated during normal walking and obstacle crossing.
RESULTS: Results revealed that decrements in gait performance in individuals with PD were amplified during obstacle crossing, suggesting that due to disease-related degradation, individuals with PD chose a more conservative strategy for obstacle crossing. Moreover, an increased duration of single limb support (18% increase), a decrease in anteroposterior range of motion (20% decrease), and an increase in mediolateral range of motion (36% increase, though not significant) coupled with the reduction in the distance between the center of pressure and center of mass (mean of 21% decrease across toe-off and heel strike) and increase in margin of stability (31% increase at toe-off and 71% increase at heel strike) may suggest that deficits in muscle strength and balance may contribute to this impairment.
CONCLUSIONS: Persons with PD alter their behavior to reduce the mechanical demands and increase dynamic stability during obstacle avoidance tasks.
Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Entities:  

Mesh:

Year:  2012        PMID: 22318131     DOI: 10.1016/j.apmr.2011.11.004

Source DB:  PubMed          Journal:  Arch Phys Med Rehabil        ISSN: 0003-9993            Impact factor:   3.966


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