Postural instability and gait impairment during obstacle crossing in Parkinson's disease.
OBJECTIVE
To examine whether Parkinson's disease (PD) affects gait behavior and stability while walking over an obstacle.


METHODS
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.


METHODS
University biomechanics laboratory.


METHODS
Individuals with PD (n=10) and age- and sex-matched healthy older adults (n=10).


METHODS
Not applicable.


METHODS
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.
Department of Applied Physiology and Kinesiology and Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL 32611, USA.
Elizabeth L
EL
Stegemöller
Thomas A
TA
Buckley
Chris
C
Pitsikoulis
Ernest
E
Barthelemy
Ryan
R
Roemmich
Chris J
CJ
Hass
D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology*; D016138:Walking / Q000502:physiology*