title: Evaluating the acute contributions of dopaminergic replacement to gait with obstacles in Parkinson's disease.
abstract: The influence of dopaminergic replacement (DR) on gait in people with Parkinson's disease (PD) is well documented. However, little is known about the acute effects of dopamine on more complex locomotor tasks that require visual guidance to avoid obstacles during gait. The authors investigated the influence of DR on locomotor behavior in a task where movement planning and control might be challenged by the height of the obstacle. The PD group included patients diagnosed with idiopathic PD (n = 12), as well as healthy controls (n = 12). Patients walked and stepped over obstacles of different heights before (OFF) and after (ON) levodopa intake. Spatial adjustments were not modulated by DR, but the step time to perform these anticipatory gait adjustments was longer only in PD-OFF (compared with healthy controls) when approaching the highest obstacle, but not PD-ON. During the crossing phase, trail limb toe clearance of PD patients was shorter than healthy controls only during the OFF state. ON-OFF comparisons were significantly different only for the time to reach the lead foot clearance over the highest obstacle. In summary, DR partially improved movement slowness but did not directly affect movement amplitude of lower limb regulation in this gait task.
authors.affiliation: Posture and Gait Studies Lab, Physical Education Department, University of Sao Paulo State, Brazil. ikopif@hotmail.com
authors.forename: F
authors.initials: F
authors.lastname: Pieruccini-Faria
authors.forename: R
authors.initials: R
authors.lastname: Vitório
authors.forename: Q J
authors.initials: QJ
authors.lastname: Almeida
authors.forename: C R A
authors.initials: CR
authors.lastname: Silveira
authors.forename: M J D
authors.initials: MJ
authors.lastname: Caetano
authors.forename: F
authors.initials: F
authors.lastname: Stella
authors.forename: S
authors.initials: S
authors.lastname: Gobbi
authors.forename: L T B
authors.initials: LT
authors.lastname: Gobbi
mesh_terms: D000368:Aged; D059031:Anticipation, Psychological / Q000502:physiology; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D001696:Biomechanical Phenomena; D003463:Cues; D003627:Data Interpretation, Statistical; D015259:Dopamine Agents / Q000627:therapeutic use*; D005260:Female; D005528:Foot / Q000502:physiology; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology*; D010775:Photic Stimulation; D011434:Proprioception / Q000502:physiology; D015203:Reproducibility of Results
chemical_list: D000978:Antiparkinson Agents; D015259:Dopamine Agents; D007980:Levodopa