Impaired Weight-Shift Amplitude in People with Parkinson’s Disease with Freezing of Gait

2021 ◽  
pp. 1-14
Author(s):  
Bauke Wybren Dijkstra ◽  
Moran Gilat ◽  
L. Eduardo Cofré Lizama ◽  
Martina Mancini ◽  
Bruno Bergmans ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Balance Control ◽  
Dynamic Balance ◽  
Center Of Mass ◽  
Freezing Of Gait ◽  
Dopaminergic Medication ◽  
Weight Shift ◽  
Future Work ◽  
Weight Shifting

Background: People with Parkinson’s disease and freezing of gait (FOG; freezers) suffer from pronounced postural instability. However, the relationship between these phenomena remains unclear and has mostly been tested in paradigms requiring step generation. Objective: To determine if freezing-related dynamic balance deficits are present during a task without stepping and determine the influence of dopaminergic medication on dynamic balance control. Methods: Twenty-two freezers, 16 non-freezers, and 20 healthy age-matched controls performed mediolateral weight-shifts at increasing frequencies when following a visual target projected on a screen (MELBA task). The amplitude and phase shift differences between center of mass and target motion were measured. Balance scores (Mini-BESTest), 360° turning speed and the freezing ratio were also measured. Subjects with Parkinson’s disease were tested ON and partial OFF (overnight withdrawal) dopaminergic medication. Results: Freezers had comparable turning speed and balance scores to non-freezers and took more levodopa. Freezers produced hypokinetic weight-shift amplitudes throughout the MELBA task compared to non-freezers (p = 0.002), which were already present at task onset (p < 0.001). Freezers also displayed an earlier weight-shift breakdown than controls when OFF-medication (p = 0.008). Medication improved mediolateral weight-shifting in freezers and non-freezers. Freezers decreased their freezing ratio in response to medication. Conclusion: Hypokinetic weight-shifting proved a marked postural control deficit in freezers, while balance scores and turning speed were similar to non-freezers. Both weight-shift amplitudes and the freezing ratio were responsive to medication in freezers, suggesting axial motor vigor is levodopa-responsive. Future work needs to test whether weight-shifting and freezing severity can be further ameliorated through training.

scholarly journals Which Aspects of Postural Control Differentiate between Patients with Parkinson’s Disease with and without Freezing of Gait?

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Griet Vervoort ◽  
Evelien Nackaerts ◽  
Farshid Mohammadi ◽  
Elke Heremans ◽  
Sabine Verschueren ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Freezing Of Gait ◽  
Sensory Information ◽  
Response Strength ◽  
Dynamic Posturography ◽  
Directional Control ◽  
Weight Shift ◽  
Weight Shifting

This exploratory study aimed to identify which aspects of postural control are able to distinguish between subgroups of patients with Parkinson’s disease (PD) and controls. Balance was tested using static and dynamic posturography. Freezers (n=9), nonfreezers (n=10), and controls (n=10) stood on a movable force platform and performed 3 randomly assigned tests: (1) sensory organization test (SOT) to evaluate the effective use of sensory information, (2) motor control test (MCT) to assess automatic postural reactions in response to platform perturbations, and (3) rhythmic weight shift test (RWS) to evaluate the ability to voluntarily move the center of gravity (COG) mediolaterally and anterior-posteriorly (AP). The respective outcome measures were equilibrium and postural strategy scores, response strength and amplitude of weight shift. Patients were in the “on” phase of the medication cycle. In general, freezers performed similarly on SOT and MCT compared to nonfreezers. Freezers showed an intact postural strategy during sensory manipulations and an appropriate response to external perturbations. However, during voluntary weight shifting, freezers showed poorer directional control compared to nonfreezers and controls. This suggests that freezers have adequate automatic postural control and sensory integration abilities in quiet stance, but show specific directional control deficits when weight shifting is voluntary.

Management of postural sensory conflict and dynamic balance control in late-stage Parkinson's disease

Neuroscience ◽  
2011 ◽  
Vol 193 ◽  
pp. 363-369 ◽  
Author(s):  
S. Colnat-Coulbois ◽  
G.C. Gauchard ◽  
L. Maillard ◽  
G. Barroche ◽  
H. Vespignani ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Late Stage ◽  
Balance Control ◽  
Dynamic Balance ◽  
Sensory Conflict

scholarly journals A synthetic kinematic index of trunk displacement conveying the overall motor condition in Parkinson’s disease

2020 ◽  
Author(s):  
Emahnuel Troisi Lopez ◽  
Roberta Minino ◽  
Pierpaolo Sorrentino ◽  
Rosaria Rucco ◽  
Anna Carotenuto ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Relevance ◽  
Balance Control ◽  
Center Of Mass ◽  
Motor Impairment ◽  
Clinical Approach ◽  
Gait Parameters ◽  
Motor Condition ◽  
Relationship Of

AbstractBACKGROUNDParkinson’s disease (PD) is characterized by motor impairment, affecting quality of life and increasing fall risk, due to ineffective postural control. To this day, the diagnosis remains based on clinical approach. Similarly, motor evaluation is based on heterogeneous, operator-dependent observational criteria. A synthetic, replicable index to quantify motor impairment is still lacking. In this paper, we build upon the idea that the trunk is crucial in balance control. Hence, we have designed a new measure of postural stability which assesses the trunk displacement in relation to the center of mass, that we named trunk displacement index (TDI).METHODSTwenty-three PD patients and twenty-three healthy controls underwent clinical (UPDRS-III) and motor examination (3D gait analysis). The TDI was extracted from kinematic measurements using a stereophotogrammetric system. A correlation analysis was performed to assess the relationship of TDI with typical gait parameters, to verify its biomechanical value, and UPDRS-III, to observe its clinical relevance. Finally, its sensitivity was measured, comparing pre- and post-L-DOPA subclinical intake.RESULTSThe TDI showed significant correlations with many gait parameters, including both velocity and stability characteristics of gait, and with the UPDRS-III. Finally, the TDI resulted capable in discriminating between off and on state in PD, whereas typical gait parameters failed two show any difference between those two conditions.CONCLUSIONSOur results suggest that the TDI may be considered a highly sensitive biomechanical index, reflecting the overall motor condition in PD, and provided of clinical relevance due to the correlation with the clinical evaluation.

scholarly journals Turning Characteristics of the More-Affected Side in Parkinson’s Disease Patients with Freezing of Gait

Sensors ◽  
2020 ◽  
Vol 20 (11) ◽  
pp. 3098
Author(s):  
Hwayoung Park ◽  
Changhong Youm ◽  
Myeounggon Lee ◽  
Byungjoo Noh ◽  
Sang-Myung Cheon
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Center Of Mass ◽  
Freezing Of Gait ◽  
Step Length ◽  
Control Group ◽  
Maximum Speed ◽  
Step Width ◽  
Affected Side ◽  
Anterior Posterior

This study investigated the turning characteristics of the more-affected limbs in Parkinson’s disease (PD) patients in comparison with that of a control group, and in PD patients with freezing of gait (FOG; freezers) in comparison with those without FOG (non-freezers) for 360° and 540° turning tasks at the maximum speed. A total of 12 freezers, 12 non-freezers, and 12 controls participated in this study. The PD patients showed significantly longer total durations, shorter inner and outer step lengths, and greater anterior–posterior (AP) root mean square (RMS) center of mass (COM) distances compared to those for the controls. The freezers showed significantly greater AP and medial-lateral (ML) RMS COM distances compared to those of non-freezers. The turning task toward the inner step of the more-affected side (IMA) in PD patients showed significantly greater step width, total steps, and AP and ML RMS COM distances than that toward the outer step of the more-affected side (OMA). The corresponding results for freezers revealed significantly higher total steps and shorter inner step length during the 540° turn toward the IMA than that toward the OMA. Therefore, PD patients and freezers exhibited greater turning difficulty in performing challenging turning tasks such as turning with an increased angle and speed and toward the more-affected side.

Center of mass trajectories during turning in patients with Parkinson's disease with and without freezing of gait

2016 ◽  
Vol 43 ◽  
pp. 54-59 ◽  
Author(s):  
A. Bengevoord ◽  
G. Vervoort ◽  
J. Spildooren ◽  
E. Heremans ◽  
W. Vandenberghe ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Center Of Mass ◽  
Freezing Of Gait

scholarly journals Abnormalities of the First Three Steps of Gait Initiation in Patients with Parkinson's Disease with Freezing of Gait

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Yohei Okada ◽  
Takahiko Fukumoto ◽  
Katsuhiko Takatori ◽  
Koji Nagino ◽  
Koichi Hiraoka
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Center Of Pressure ◽  
Freezing Of Gait ◽  
Gait Initiation ◽  
Healthy Controls ◽  
Heel Contact ◽  
Spatiotemporal Parameters ◽  
Contact Position ◽  
Weight Shifting

The purpose of this study was to investigate abnormalities of the first three steps of gait initiation in patients with Parkinson's disease (PD) with freezing of gait (FOG). Ten PD patients with FOG and 10 age-matched healthy controls performed self-generated gait initiation. The center of pressure (COP), heel contact positions, and spatiotemporal parameters were estimated from the vertical pressures on the surface of the force platform. The initial swing side of gait initiation was consistent among the trials in healthy controls but not among the trials in PD patients. The COP and the heel contact position deviated to the initial swing side during the first step, and the COP passed medial to each heel contact position during the first two steps in PD patients. Medial deviation of the COP from the first heel contact position had significant correlation with FOG questionnaire item 5. These findings indicate that weight shifting between the legs is abnormal and that medial deviation of the COP from the first heel contact position sensitively reflects the severity of FOG during the first three steps of gait initiation in PD patients with FOG.

Gait Initiation and Dynamic Balance Control in Parkinson’s Disease

2005 ◽  
Vol 86 (11) ◽  
pp. 2172-2176 ◽  
Author(s):  
Chris J. Hass ◽  
Dwight E. Waddell ◽  
Richard P. Fleming ◽  
Jorge L. Juncos ◽  
Robert J. Gregor
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Balance Control ◽  
Dynamic Balance ◽  
Gait Initiation
Sign in / Sign up

Export Citation Format

Share Document