Protective stepping response in Parkinsonian patients and the effect of vibrotactile feedback.
Identifieur interne : 000820 ( Main/Exploration ); précédent : 000819; suivant : 000821Protective stepping response in Parkinsonian patients and the effect of vibrotactile feedback.
Auteurs : Pei-Yun Lee [Royaume-Uni] ; Kris Gadareh ; Mohammad J. Naushahi ; Michael Gresty ; Adolfo M. BronsteinSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2013.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Female, Gait Disorders, Neurologic (etiology), Gait Disorders, Neurologic (physiopathology), Humans, Leg (physiology), Male, Middle Aged, Parkinson Disease (complications), Parkinson Disease (physiopathology), Postural Balance, Posture (physiology), Reaction Time, Reflex (physiology).
- MESH :
- complications : Parkinson Disease.
- etiology : Gait Disorders, Neurologic.
- physiology : Leg, Posture, Reflex.
- physiopathology : Gait Disorders, Neurologic, Parkinson Disease.
- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Postural Balance, Reaction Time.
Abstract
The objectives of this study were (1) to characterize protective stepping responses to unpredictable forward/backward postural perturbation in Parkinson's disease (PD) and (2) to assess whether vibrotactile cues of the impending fall improve the stepping response. Twenty mild PD patients, 7 advanced PD patients, and 17 age-matched controls stood on a platform moving unpredictably forward and backward, requiring a protective step to maintain balance. Direction-coded vibrotactile cues, triggered by leg tilt, were provided to prompt step generation. All subjects showed quicker reaction time, shorter steps, and smaller total trunk displacement when stepping backward than when stepping forward. Advanced PD patients took shorter, slower, and an increased number of protective steps. The only abnormality observed in mild PD patients was slightly slower backward steps. Vibrotactile feedback reduced the amount of trunk displacement observed before taking a protective step but did not improve any abnormality in PD patients. Early PD patients had near-normal protective stepping responses to unpredictable perturbations, but advanced patients made slow and short steps both forward and backward. Given that latencies were preserved even in unpredictable conditions, step slowness and hypometria are the primary abnormalities of the stepping response in PD. As voluntary locomotor stepping in PD is reported to improve with sensory feedback, the lack of such improvement in our study implies that additional sensory cues cannot help automatic reflex-like stepping reactions in PD patients.
DOI: 10.1002/mds.25227
PubMed: 23115133
Affiliations:
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Naushahi</name></author><author><name sortKey="Gresty, Michael" sort="Gresty, Michael" uniqKey="Gresty M" first="Michael" last="Gresty">Michael Gresty</name></author><author><name sortKey="Bronstein, Adolfo M" sort="Bronstein, Adolfo M" uniqKey="Bronstein A" first="Adolfo M" last="Bronstein">Adolfo M. 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Naushahi</name></author><author><name sortKey="Gresty, Michael" sort="Gresty, Michael" uniqKey="Gresty M" first="Michael" last="Gresty">Michael Gresty</name></author><author><name sortKey="Bronstein, Adolfo M" sort="Bronstein, Adolfo M" uniqKey="Bronstein A" first="Adolfo M" last="Bronstein">Adolfo M. Bronstein</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Gait Disorders, Neurologic (etiology)</term><term>Gait Disorders, Neurologic (physiopathology)</term><term>Humans</term><term>Leg (physiology)</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (physiopathology)</term><term>Postural Balance</term><term>Posture (physiology)</term><term>Reaction Time</term><term>Reflex (physiology)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Gait Disorders, Neurologic</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Leg</term><term>Posture</term><term>Reflex</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Gait Disorders, Neurologic</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Postural Balance</term><term>Reaction Time</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The objectives of this study were (1) to characterize protective stepping responses to unpredictable forward/backward postural perturbation in Parkinson's disease (PD) and (2) to assess whether vibrotactile cues of the impending fall improve the stepping response. Twenty mild PD patients, 7 advanced PD patients, and 17 age-matched controls stood on a platform moving unpredictably forward and backward, requiring a protective step to maintain balance. Direction-coded vibrotactile cues, triggered by leg tilt, were provided to prompt step generation. All subjects showed quicker reaction time, shorter steps, and smaller total trunk displacement when stepping backward than when stepping forward. Advanced PD patients took shorter, slower, and an increased number of protective steps. The only abnormality observed in mild PD patients was slightly slower backward steps. Vibrotactile feedback reduced the amount of trunk displacement observed before taking a protective step but did not improve any abnormality in PD patients. Early PD patients had near-normal protective stepping responses to unpredictable perturbations, but advanced patients made slow and short steps both forward and backward. Given that latencies were preserved even in unpredictable conditions, step slowness and hypometria are the primary abnormalities of the stepping response in PD. As voluntary locomotor stepping in PD is reported to improve with sensory feedback, the lack of such improvement in our study implies that additional sensory cues cannot help automatic reflex-like stepping reactions in PD patients.</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><noCountry><name sortKey="Bronstein, Adolfo M" sort="Bronstein, Adolfo M" uniqKey="Bronstein A" first="Adolfo M" last="Bronstein">Adolfo M. Bronstein</name><name sortKey="Gadareh, Kris" sort="Gadareh, Kris" uniqKey="Gadareh K" first="Kris" last="Gadareh">Kris Gadareh</name><name sortKey="Gresty, Michael" sort="Gresty, Michael" uniqKey="Gresty M" first="Michael" last="Gresty">Michael Gresty</name><name sortKey="Naushahi, Mohammad J" sort="Naushahi, Mohammad J" uniqKey="Naushahi M" first="Mohammad J" last="Naushahi">Mohammad J. Naushahi</name></noCountry><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Lee, Pei Yun" sort="Lee, Pei Yun" uniqKey="Lee P" first="Pei-Yun" last="Lee">Pei-Yun Lee</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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