Improved asymmetry of gait in Parkinson's disease with DBS: Gait and postural instability in Parkinson's disease treated with bilateral deep brain stimulation in the subthalamic nucleus
Identifieur interne : 000A63 ( Main/Exploration ); précédent : 000A62; suivant : 000A64Improved asymmetry of gait in Parkinson's disease with DBS: Gait and postural instability in Parkinson's disease treated with bilateral deep brain stimulation in the subthalamic nucleus
Auteurs : Erik L. Johnsen [Danemark] ; Poul H. Mogensen [Danemark] ; Niels Aa. Sunde [Danemark] ; Karen Stergaard [Danemark]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-03-15.
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Abstract
Postural instability is a sign of progression of Parkinson's disease (PD) and often resistant to levodopa treatment. To explore the effect of bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) on postural stability and gait, full body gait analyses were performed without medication, OFF and ON DBS in eight PD patients and 12 healthy age‐matched controls. DBS setting was changed at least 3 hours before gait analysis. To describe asymmetry most and least affected sides (MAS and LAS) were rated with the Unified Parkinson's Disease Rating Scale, motor part and quantitative gait analysis with the Vicon 612 gait analysis system. Stride length and gait velocity but not cadence improved ON DBS. The distances between the heel markers and center of mass (COM) were asymmetric and reduced OFF DBS. STN DBS increased the distances significantly and reduced asymmetry. The improvement in heel to COM distance was larger on the MAS compared with the LAS. OFF DBS knee momentum asymmetry was inversed so that LAS was more impaired than MAS. ON DBS asymmetry improved. PD patients OFF DBS place the heel too close to COM. The most affected body side has the most impaired swing and the result is a smaller knee moment on the opposite and least affected body side and an asymmetric gait pattern with disturbed balance OFF STN DBS. The asymmetry OFF DBS improved ON DBS. We suggest that DBS facilitates symmetric gait and thereby improves balance during gait. © 2008 Movement Disorder Society
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DOI: 10.1002/mds.22419
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-03-15">2009-03-15</date><biblScope unit="volume">24</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="588">588</biblScope><biblScope unit="page" to="595">595</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">DBFB636B879E3BF576806E55BE08E8CBF71DC601</idno><idno type="DOI">10.1002/mds.22419</idno><idno type="ArticleID">MDS22419</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>deep brain stimulation</term><term>gait and postural instability</term><term>subthalamic nucleus</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Postural instability is a sign of progression of Parkinson's disease (PD) and often resistant to levodopa treatment. To explore the effect of bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) on postural stability and gait, full body gait analyses were performed without medication, OFF and ON DBS in eight PD patients and 12 healthy age‐matched controls. DBS setting was changed at least 3 hours before gait analysis. To describe asymmetry most and least affected sides (MAS and LAS) were rated with the Unified Parkinson's Disease Rating Scale, motor part and quantitative gait analysis with the Vicon 612 gait analysis system. Stride length and gait velocity but not cadence improved ON DBS. The distances between the heel markers and center of mass (COM) were asymmetric and reduced OFF DBS. STN DBS increased the distances significantly and reduced asymmetry. The improvement in heel to COM distance was larger on the MAS compared with the LAS. OFF DBS knee momentum asymmetry was inversed so that LAS was more impaired than MAS. ON DBS asymmetry improved. PD patients OFF DBS place the heel too close to COM. The most affected body side has the most impaired swing and the result is a smaller knee moment on the opposite and least affected body side and an asymmetric gait pattern with disturbed balance OFF STN DBS. The asymmetry OFF DBS improved ON DBS. We suggest that DBS facilitates symmetric gait and thereby improves balance during gait. © 2008 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Danemark</li></country></list><tree><country name="Danemark"><noRegion><name sortKey="Johnsen, Erik L" sort="Johnsen, Erik L" uniqKey="Johnsen E" first="Erik L." last="Johnsen">Erik L. Johnsen</name></noRegion><name sortKey=" Stergaard, Karen" sort=" Stergaard, Karen" uniqKey=" Stergaard K" first="Karen" last=" Stergaard">Karen Stergaard</name><name sortKey="Mogensen, Poul H" sort="Mogensen, Poul H" uniqKey="Mogensen P" first="Poul H." last="Mogensen">Poul H. Mogensen</name><name sortKey="Sunde, Niels Aa" sort="Sunde, Niels Aa" uniqKey="Sunde N" first="Niels Aa." last="Sunde">Niels Aa. Sunde</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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