Background: Parkinson’s disease (PD) exacerbates muscle and bone mass loss, which is associated with several negative outcomes such as falls and disability. Thus, muscle and bone mass loss may be one mechanism for the mediator role between gait impairments and PD. Aim: To verify the relationship between the spatial-temporal gait parameters and the body composition of the lower limbs in people with PD. Method: Thirteen people with PD were evaluated on two different days: i) clinical and gait evaluation; ii) body composition evaluation. The step length, width, duration and speed, the percentage in double support, and gait velocity during walking at self-selected velocity. Dual-energy X-ray absorptiometry technique was used to measure fat mass, lean mass, bone mass, and the total mass, for whole body, and separately for each limb. Pearson’s correlation coefficients were applied between the spatial-temporal gait parameters and the variables of body composition of lower limbs. Results: Reduced lean and bone mass of both legs were related to faster gait velocity (r=0.6, p<0.03 and r=0.7, p<0.01, respectively) and step speed (r=0.5, p<0.05 and r=0.65, p<0.02, respectively). Also, narrower step width was related to the higher bone mass of both legs (r=0.6, p<0.03). However, muscle and bone mass did not correlate with step length and duration, and percentage of double support. Interpretation:Our findings suggest that the muscle and bone mass of the lower limbs are important body characteristics for gait impairments in people with PD and should be monitored over the disease.
BackgroundGait asymmetry and deficits in gait initiation (GI) are among the most disabling symptoms in people with Parkinson’s disease (PwPD). Understanding if PwPD with reduced asymmetry during GI have higher asymmetry in cortical activity may provide support for an adaptive mechanism to improve GI, particularly in the presence of an obstacle.ObjectiveThis study quantified the asymmetry of anticipatory postural adjustments (APAs), stepping parameters and cortical activity during GI, and tested if the presence of an obstacle regulates asymmetry in PwPD.MethodsSixteen PwPD and 16 control group (CG) performed 20-trials in two conditions: unobstructed and obstructed GI with right and left limbs. We measured, through symmetry index, (i) motor parameters: APAs and stepping, and (ii) cortical activity: the PSD of the frontal, sensorimotor and occipital areas during APA, STEP-I (moment of heel-off of the leading foot in the GI until the heel contact of the same foot); and STEP-II (moment of the heel-off of the trailing foot in the GI until the heel contact of the same foot) phases.ResultsParkinson’s disease showed higher asymmetry in cortical activity during APA, STEP-I and STEP-II phases and step velocity (STEP-II phase) during unobstructed GI than CG. However, unexpectedly, PwPD reduced the level of asymmetry of anterior–posterior displacement (p < 0.01) and medial-lateral velocity (p < 0.05) of the APAs. Also, when an obstacle was in place, PwPD showed higher APAs asymmetry (medial-lateral velocity: p < 0.002), with reduced and increased asymmetry of the cortical activity during APA and STEP-I phases, respectively.ConclusionParkinson’s disease were not motor asymmetric during GI, indicating that higher cortical activity asymmetry can be interpreted as an adaptive behavior to reduce motor asymmetry. In addition, the presence of obstacle did not regulate motor asymmetry during GI in PwPD.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.