The effect of moderate Parkinson's disease on compensatory backwards stepping

Molly A. McVey; Sommer Amundsen; Annaria Barnds; Kelly E. Lyons; Rajesh Pahwa; Jonathan D. Mahnken; Carl W. Luchies

doi:10.1016/j.gaitpost.2013.03.028

The effect of moderate Parkinson's disease on compensatory backwards stepping

Molly A. McVey, Sommer Amundsen, Annaria Barnds, Kelly E. Lyons, Rajesh Pahwa, Jonathan D. Mahnken, Carl W. Luchies

Neurology

Research output: Contribution to journal › Article › peer-review

20 Scopus citations

Abstract

Postural instability is a major unmet need in the treatment of Parkinson's disease (PD) and its progression is not well understood. This study examined compensatory stepping taken in response to a backwards waist pull in participants with moderate PD (H&Y III) compared to age-range matched healthy controls (HC). The first step in the response was quantified in terms of strategy, temporal, kinematic, and center of pressure (COP) parameters previously observed to be significantly different in mild PD (H&Y II) compared to HC. Patients with moderate PD, compared to HC, utilized more steps to regain balance, had a longer weight-shift-time, and utilized a base-width neutral step to regain balance. However, there were no differences in ankle angle or COP location at landing as observed in mild PD, possibly due to the use of the base-width neutral step. These results suggest that moderate PD significantly impairs the compensatory response to a backwards pull. Further study should examine the progression of impairment in compensatory responses across PD severity levels, and the correlation with fall risk.

Original language	English (US)
Pages (from-to)	800-805
Number of pages	6
Journal	Gait and Posture
Volume	38
Issue number	4
DOIs	https://doi.org/10.1016/j.gaitpost.2013.03.028
State	Published - Sep 2013

Bibliographical note

Funding Information:
The authors wish to thank David Thomas for his assistance with data collection. This research was supported by the Madison and Lila Self Graduate Fellowship and the KU Mechanical Engineering Department .

Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.

Keywords

Balance
Balance recovery
Compensatory Stepping
Falls
Parkinson's disease

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10.1016/j.gaitpost.2013.03.028

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title = "The effect of moderate Parkinson's disease on compensatory backwards stepping",

abstract = "Postural instability is a major unmet need in the treatment of Parkinson's disease (PD) and its progression is not well understood. This study examined compensatory stepping taken in response to a backwards waist pull in participants with moderate PD (H&Y III) compared to age-range matched healthy controls (HC). The first step in the response was quantified in terms of strategy, temporal, kinematic, and center of pressure (COP) parameters previously observed to be significantly different in mild PD (H&Y II) compared to HC. Patients with moderate PD, compared to HC, utilized more steps to regain balance, had a longer weight-shift-time, and utilized a base-width neutral step to regain balance. However, there were no differences in ankle angle or COP location at landing as observed in mild PD, possibly due to the use of the base-width neutral step. These results suggest that moderate PD significantly impairs the compensatory response to a backwards pull. Further study should examine the progression of impairment in compensatory responses across PD severity levels, and the correlation with fall risk.",

keywords = "Balance, Balance recovery, Compensatory Stepping, Falls, Parkinson's disease",

author = "McVey, {Molly A.} and Sommer Amundsen and Annaria Barnds and Lyons, {Kelly E.} and Rajesh Pahwa and Mahnken, {Jonathan D.} and Luchies, {Carl W.}",

note = "Funding Information: The authors wish to thank David Thomas for his assistance with data collection. This research was supported by the Madison and Lila Self Graduate Fellowship and the KU Mechanical Engineering Department . Copyright: Copyright 2013 Elsevier B.V., All rights reserved.",

year = "2013",

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AU - Amundsen, Sommer

AU - Barnds, Annaria

AU - Lyons, Kelly E.

AU - Pahwa, Rajesh

AU - Mahnken, Jonathan D.

AU - Luchies, Carl W.

N1 - Funding Information: The authors wish to thank David Thomas for his assistance with data collection. This research was supported by the Madison and Lila Self Graduate Fellowship and the KU Mechanical Engineering Department . Copyright: Copyright 2013 Elsevier B.V., All rights reserved.

PY - 2013/9

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N2 - Postural instability is a major unmet need in the treatment of Parkinson's disease (PD) and its progression is not well understood. This study examined compensatory stepping taken in response to a backwards waist pull in participants with moderate PD (H&Y III) compared to age-range matched healthy controls (HC). The first step in the response was quantified in terms of strategy, temporal, kinematic, and center of pressure (COP) parameters previously observed to be significantly different in mild PD (H&Y II) compared to HC. Patients with moderate PD, compared to HC, utilized more steps to regain balance, had a longer weight-shift-time, and utilized a base-width neutral step to regain balance. However, there were no differences in ankle angle or COP location at landing as observed in mild PD, possibly due to the use of the base-width neutral step. These results suggest that moderate PD significantly impairs the compensatory response to a backwards pull. Further study should examine the progression of impairment in compensatory responses across PD severity levels, and the correlation with fall risk.

AB - Postural instability is a major unmet need in the treatment of Parkinson's disease (PD) and its progression is not well understood. This study examined compensatory stepping taken in response to a backwards waist pull in participants with moderate PD (H&Y III) compared to age-range matched healthy controls (HC). The first step in the response was quantified in terms of strategy, temporal, kinematic, and center of pressure (COP) parameters previously observed to be significantly different in mild PD (H&Y II) compared to HC. Patients with moderate PD, compared to HC, utilized more steps to regain balance, had a longer weight-shift-time, and utilized a base-width neutral step to regain balance. However, there were no differences in ankle angle or COP location at landing as observed in mild PD, possibly due to the use of the base-width neutral step. These results suggest that moderate PD significantly impairs the compensatory response to a backwards pull. Further study should examine the progression of impairment in compensatory responses across PD severity levels, and the correlation with fall risk.

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KW - Parkinson's disease

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The effect of moderate Parkinson's disease on compensatory backwards stepping

Abstract

Bibliographical note

Keywords

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