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Variability of Anticipatory Postural Adjustments During Gait Initiation in Individuals With Parkinson Disease.
J Neurol Phys Ther. 2016 Jan; 40(1):40-6.JN

Abstract

BACKGROUND AND PURPOSE

In people with Parkinson disease (PD), difficulties with initiating stepping may be related to impairments of anticipatory postural adjustments (APAs). Increased variability in step length and step time has been observed in gait initiation in individuals with PD. In this study, we investigated whether the ability to generate consistent APAs during gait initiation is compromised in these individuals.

METHODS

Fifteen subjects with PD and 8 healthy control subjects were instructed to take rapid forward steps after a verbal cue. The changes in vertical force and ankle marker position were recorded via force platforms and a 3-dimensional motion capture system, respectively. Means, standard deviations, and coefficients of variation of both timing and magnitude of vertical force, as well as stepping variables, were calculated.

RESULTS

During the postural phase of gait initiation the interval was longer and the force modulation was smaller in subjects with PD. Both the variability of timing and force modulation were larger in subjects with PD. Individuals with PD also had a longer time to complete the first step, but no significant differences were found for the variability of step time, length, and speed between groups.

DISCUSSION AND CONCLUSIONS

The increased variability of APAs during gait initiation in subjects with PD could affect posture-locomotion coupling, and lead to start hesitation, and even falls. Future studies are needed to investigate the effect of rehabilitation interventions on the variability of APAs during gait initiation in individuals with PD.Video abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A119).

Authors+Show Affiliations

Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, Maryland.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26630325

Citation

Lin, Cheng-Chieh, et al. "Variability of Anticipatory Postural Adjustments During Gait Initiation in Individuals With Parkinson Disease." Journal of Neurologic Physical Therapy : JNPT, vol. 40, no. 1, 2016, pp. 40-6.
Lin CC, Creath RA, Rogers MW. Variability of Anticipatory Postural Adjustments During Gait Initiation in Individuals With Parkinson Disease. J Neurol Phys Ther. 2016;40(1):40-6.
Lin, C. C., Creath, R. A., & Rogers, M. W. (2016). Variability of Anticipatory Postural Adjustments During Gait Initiation in Individuals With Parkinson Disease. Journal of Neurologic Physical Therapy : JNPT, 40(1), 40-6. https://doi.org/10.1097/NPT.0000000000000112
Lin CC, Creath RA, Rogers MW. Variability of Anticipatory Postural Adjustments During Gait Initiation in Individuals With Parkinson Disease. J Neurol Phys Ther. 2016;40(1):40-6. PubMed PMID: 26630325.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Variability of Anticipatory Postural Adjustments During Gait Initiation in Individuals With Parkinson Disease. AU - Lin,Cheng-Chieh, AU - Creath,Robert A, AU - Rogers,Mark W, PY - 2015/12/3/entrez PY - 2015/12/3/pubmed PY - 2016/9/16/medline SP - 40 EP - 6 JF - Journal of neurologic physical therapy : JNPT JO - J Neurol Phys Ther VL - 40 IS - 1 N2 - BACKGROUND AND PURPOSE: In people with Parkinson disease (PD), difficulties with initiating stepping may be related to impairments of anticipatory postural adjustments (APAs). Increased variability in step length and step time has been observed in gait initiation in individuals with PD. In this study, we investigated whether the ability to generate consistent APAs during gait initiation is compromised in these individuals. METHODS: Fifteen subjects with PD and 8 healthy control subjects were instructed to take rapid forward steps after a verbal cue. The changes in vertical force and ankle marker position were recorded via force platforms and a 3-dimensional motion capture system, respectively. Means, standard deviations, and coefficients of variation of both timing and magnitude of vertical force, as well as stepping variables, were calculated. RESULTS: During the postural phase of gait initiation the interval was longer and the force modulation was smaller in subjects with PD. Both the variability of timing and force modulation were larger in subjects with PD. Individuals with PD also had a longer time to complete the first step, but no significant differences were found for the variability of step time, length, and speed between groups. DISCUSSION AND CONCLUSIONS: The increased variability of APAs during gait initiation in subjects with PD could affect posture-locomotion coupling, and lead to start hesitation, and even falls. Future studies are needed to investigate the effect of rehabilitation interventions on the variability of APAs during gait initiation in individuals with PD.Video abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A119). SN - 1557-0584 UR - https://www.unboundmedicine.com/medline/citation/26630325/Variability_of_Anticipatory_Postural_Adjustments_During_Gait_Initiation_in_Individuals_With_Parkinson_Disease_ L2 - https://doi.org/10.1097/NPT.0000000000000112 DB - PRIME DP - Unbound Medicine ER -