title: Effects of dopamine replacement therapy on lower extremity kinetics and kinematics during a rapid force production task in persons with Parkinson disease.
abstract: Postural instability appears to be a dopamine resistance motor deficit in persons with Parkinson disease (PD); however, little is known about the effects of dopamine replacement on the relative biomechanical contributions of individual lower extremity joints during postural control tasks. To gain insight, we examined persons with PD using both clinical and laboratory measures. For a clinical measure of motor severity we utilized the Unified Parkinson Disease Rating Scale motor subsection during both OFF and ON medication conditions. For the laboratory measure we utilized data gathered during a rapid lower extremity force production task. Kinematic and kinetic variables at the hip, knee, and ankle were gathered during a counter movement jump during both OFF and ON medication conditions. Sixteen persons with PD with a median Hoehn and Yahr severity of 2.5 completed the study. Medication resulted in significant improvements of angular displacement for the hip, knee, and ankle. Furthermore, significant improvements were revealed only at the hip for peak net moments and average angular velocity compared to the OFF medication condition. These results suggest that dopamine replacement medication result in decreased clinical motor disease severity and have a greater influence on kinetics and kinematics proximally. This proximally focused improvement may be due to active recruitment of muscle force and reductions in passive restraint during lower extremity rapid force production.
authors: Department of Physical Therapy, University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, United States. Electronic address: bo.Foreman@hsc.utah.edu.
authors: K Bo
authors: KB
authors: Foreman
authors: Madeline L
authors: ML
authors: Singer
authors: Odessa
authors: O
authors: Addison
authors: Robin L
authors: RL
authors: Marcus
authors: Paul C
authors: PC
authors: LaStayo
authors: Leland E
authors: LE
authors: Dibble
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000502:physiology; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D001696:Biomechanical Phenomena; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D015259:Dopamine Agents / Q000627:therapeutic use*; D005260:Female; D006621:Hip Joint / Q000502:physiology; D006801:Humans; D007700:Kinetics; D007719:Knee Joint; D007866:Leg / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D002800:Cholinesterase Inhibitors; D015259:Dopamine Agents
keywords: Balance; Counter movement jump; Parkinson disease
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