Acute effects of a lateral postural assist on voluntary step initiation in patients with Parkinson's disease.
Anticipatory postural adjustments (APAs) for lateral weight transfer and stability precede and accompany voluntary stepping. Patients with Parkinson's disease (PD) show delays in step initiation with altered APA characteristics that may reflect impaired interactions between posture and locomotion. The purpose of this study was to examine the influence of a lateral postural assist on step initiation in patients with early stage PD while off medication and healthy controls. Subjects performed self-paced rapid forward steps. In one condition (ASSIST), the APA was assisted at onset with a lateral pull applied to the pelvis by a motor-driven robotic system. Ground reaction forces and whole body kinematics were recorded to characterize the APA and step characteristics. Overall, PD subjects had a longer APA duration (P < 0.01) and longer first step duration (P < 0.027) than Control subjects. With the ASSIST, the APA duration for both groups was shorter (P < 0.001), the step onset time was earlier (P < 0.001), and the speed of the first step became faster for PD subjects. Postural assistance affecting the interaction between posture and locomotion may have therapeutic potential for improving movement function in patients with PD.
Mille
Marie-Laure
ML
Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
Johnson Hilliard
Marjorie
M
Martinez
Katherine M
KM
Simuni
Tanya
T
Rogers
Mark W
MW
D000368:Aged; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D004576:Electromyography; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology*; D004856:Postural Balance; D011187:Posture / Q000502:physiology*