Christian Schlenstedt1, Martina Mancini2, Fay Horak2, Daniel Peterson3. 1. Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR; Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany. 2. Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR. 3. Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR; Department of Exercise Science & Health Promotion, Arizona State University, Phoenix, AZ. Electronic address: Daniel.Peterson1@asu.edu.
Abstract
OBJECTIVE: To characterize anticipatory postural adjustments (APAs) across a variety of step initiation tasks in people with Parkinson disease (PD) and healthy subjects. DESIGN: Cross-sectional study. Step initiation was analyzed during self-initiated gait, perceptual cued gait, and compensatory forward stepping after platform perturbation. People with PD were assessed on and off levodopa. SETTING: University research laboratory. PARTICIPANTS: People (N=31) with PD (n=19) and healthy aged-matched subjects (n=12). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Mediolateral (ML) size of APAs (calculated from center of pressure recordings), step kinematics, and body alignment. RESULTS: With respect to self-initiated gait, the ML size of APAs was significantly larger during the cued condition and significantly smaller during the compensatory condition (P<.001). Healthy subjects and patients with PD did not differ in body alignment during the stance phase prior to stepping. No significant group effect was found for ML size of APAs between healthy subjects and patients with PD. However, the reduction in APA size from cued to compensatory stepping was significantly less pronounced in PD off medication compared with healthy subjects, as indicated by a significant group by condition interaction effect (P<.01). No significant differences were found comparing patients with PD on and off medications. CONCLUSIONS: Specific stepping conditions had a significant effect on the preparation and execution of step initiation. Therefore, APA size should be interpreted with respect to the specific stepping condition. Across-task changes in people with PD were less pronounced compared with healthy subjects. Antiparkinsonian medication did not significantly improve step initiation in this mildly affected PD cohort.
OBJECTIVE: To characterize anticipatory postural adjustments (APAs) across a variety of step initiation tasks in people with Parkinson disease (PD) and healthy subjects. DESIGN: Cross-sectional study. Step initiation was analyzed during self-initiated gait, perceptual cued gait, and compensatory forward stepping after platform perturbation. People with PD were assessed on and off levodopa. SETTING: University research laboratory. PARTICIPANTS: People (N=31) with PD (n=19) and healthy aged-matched subjects (n=12). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Mediolateral (ML) size of APAs (calculated from center of pressure recordings), step kinematics, and body alignment. RESULTS: With respect to self-initiated gait, the ML size of APAs was significantly larger during the cued condition and significantly smaller during the compensatory condition (P<.001). Healthy subjects and patients with PD did not differ in body alignment during the stance phase prior to stepping. No significant group effect was found for ML size of APAs between healthy subjects and patients with PD. However, the reduction in APA size from cued to compensatory stepping was significantly less pronounced in PD off medication compared with healthy subjects, as indicated by a significant group by condition interaction effect (P<.01). No significant differences were found comparing patients with PD on and off medications. CONCLUSIONS: Specific stepping conditions had a significant effect on the preparation and execution of step initiation. Therefore, APA size should be interpreted with respect to the specific stepping condition. Across-task changes in people with PD were less pronounced compared with healthy subjects. Antiparkinsonian medication did not significantly improve step initiation in this mildly affected PD cohort.
Authors: Chris J Hass; Dwight E Waddell; Richard P Fleming; Jorge L Juncos; Robert J Gregor Journal: Arch Phys Med Rehabil Date: 2005-11 Impact factor: 3.966
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Authors: Christian Schlenstedt; Martina Mancini; Jay Nutt; Amie P Hiller; Walter Maetzler; Günther Deuschl; Fay Horak Journal: Front Aging Neurosci Date: 2018-02-15 Impact factor: 5.750
Authors: Naoya Hasegawa; Vrutangkumar V Shah; Patricia Carlson-Kuhta; John G Nutt; Fay B Horak; Martina Mancini Journal: Sensors (Basel) Date: 2019-07-28 Impact factor: 3.576