Effects of aging and Parkinson's disease on joint coupling, symmetry, complexity and variability of lower limb movements during gait

Park, Kiwon; Roemmich, Ryan T.; Elrod, Jonathan M.; Hass, Christopher J.; Hsiao-Wecksler, Elizabeth T.

doi:10.1016/j.clinbiomech.2016.02.012

Cited by 23 publications

(17 citation statements)

References 31 publications

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“…In addition, the peak velocity of arm during walking, stride duration, double support time, cadence, and trunk movement can also be improved [4,8]. However, most studies focused on spatiotemporal gait parameters which are insufficient to elucidate complex gait characteristics in patients with PD [9,10]. e changes of these spatiotemporal gait parameters in patients with PD remain controversial.…”

Section: Introductionmentioning

confidence: 99%

Wearable Sensors Measure Ankle Joint Changes of Patients with Parkinson’s Disease before and after Acute Levodopa Challenge

Jiang

Zhong

et al. 2020

Parkinson's Disease

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Background. Previous studies found levodopa could improve the activity of the ankle joints of patients with Parkinson’s disease (PD). But ankle joint movement is composed of four motion ranges. The specific changes of four motion ranges in PD remain unknown. Objective. The purpose of this study was to decompose the complex ankle joint movement, measure ankle joint changes before and after the acute levodopa challenge test (ALCT), and investigate the effects of these parameters on gait performance. Methods. 29 PD patients and 30 healthy control subjects (HC) completed the Instrumented Stand and Walk (ISAW) test and gait parameters were collected by the JiBuEn gait analysis system. The percentage of improvement of gait data and the UPDRS III in the on-drug condition (ON) were determined with respect to the off-drug condition (OFF). Results. We observed a reduction in the heel strike angle (HS), 3-plantarflexion (3-PF) angle, and 4-dorsiflexion (4-DF) angle of ankle joints. We did not find significant difference in the toe-off angle (TO), 1-plantarflexion (1-PF) angle, and 2-dorsiflexion (2-DF) angle among three groups. Stride length improvement rate was significantly correlated with HS (rs = 0.616, P<0.001) and 3-PF (rs = 0.639, P<0.001) improvement rates. The improvement in the sum of rigidity items (UPDRS motor subsection item 22) was also correlated with HS (rs = 0.389, P=0.037) and 3-PF (rs = 0.373, P=0.046) improvement rates. Conclusions. Exogenous levodopa supplementation can significantly reduce the rigidity of patients with PD, improve their 3-PF and 4-DF of ankle joint kinematic parameters, and ultimately enhance their gait.

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Section: Introductionmentioning

confidence: 99%

Wearable Sensors Measure Ankle Joint Changes of Patients with Parkinson’s Disease before and after Acute Levodopa Challenge

Jiang

Zhong

et al. 2020

Parkinson's Disease

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“…So far, TSI has been used in studies that compare the running gait of able-bodied subjects and in assessing different prosthetic knees [23, 24]. Other methods that has been used to identify the gait asymmetry from the time curves of biomechanical variables include cross-correlation [25, 26] and region of deviation analysis [27, 28],…”

Section: Introductionmentioning

confidence: 99%

Kinematic and biomimetic assessment of a hydraulic ankle/foot in level ground and camber walking

et al. 2017

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Improved walking comfort has been linked with better bio-mimicking of the prosthetic ankle. This study investigated if a hydraulic ankle/foot can provide enough motion in both the sagittal and frontal planes during level and camber walking and if the hydraulic ankle/foot better mimics the biological ankle moment pattern compared with a fixed ankle/foot device. Five active male unilateral trans-femoral amputees performed level ground walking at normal and fast speeds and 2.5° camber walking in both directions using their own prostheses fitted with an “Echelon” hydraulic ankle/foot and an “Esprit” fixed ankle/foot. Ankle angles and the Trend Symmetry Index of the ankle moments were compared between prostheses and walking conditions. Significant differences between prostheses were found in the stance plantarflexion and dorsiflexion peaks with a greater range of motion being reached with the Echelon foot. The Echelon foot also showed significantly improved bio-mimicry of the ankle resistance moment in all walking conditions, either compared with the intact side of the same subject or with the “normal” mean curve from non-amputees. During camber walking, both types of ankle/foot devices showed similar changes in the frontal plane ankle angles. Results from a questionnaire showed the subjects were more satisfied with Echelon foot.

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“…We also showed that muscle activity asymmetry was related to motor dysfunction before participants began the PT-RAS intervention. Although gait asymmetry is regularly reported in PD ( 21 – 24 , 54 , 55 ), few studies have reported on correlations between muscle activity asymmetry and disease severity. The linear relationships between GL asymmetry and dysfunction suggest that bilateral neuromuscular coordination deteriorates with more severe PD.…”

Section: Discussionmentioning

confidence: 99%

“…Gait asymmetry also seems to have an important functional role in PD. Similar to gait variability, the bilateral asymmetry of gait spatiotemporal and joint kinematic features is consistently higher in persons with PD ( 21 , 23 , 24 ). To our knowledge, only two studies have investigated neuromuscular asymmetry in PD using EMG ( 10 , 22 ).…”

Section: Introductionmentioning

confidence: 88%

“…This is of particular concern for persons with PD, as this population experiences frequent falls ( 7 , 19 , 20 ) and has a higher risk of falling than similarly aged healthy adults ( 7 ). However, individual joint kinematic variability during gait has been shown to not significantly differ between individuals with PD and similarly aged healthy adults ( 21 ), suggesting that stride-to-stride variability may instead originate from neuromuscular control deficits that are better studied using EMG. The effects of PD on EMG variability have rarely been studied.…”

Section: Introductionmentioning

confidence: 99%

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Electromyographical Gait Characteristics in Parkinson’s Disease: Effects of Combined Physical Therapy and Rhythmic Auditory Stimulation

et al. 2018

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BackgroundIn persons with Parkinson’s disease (PD), gait dysfunctions are often associated with abnormal neuromuscular function. Physical therapy combined with auditory stimulation has been recently shown to improve motor function and gait kinematic patterns; however, the underlying neuromuscular control patterns leading to this improvement have never been identified.Objectives(1) Assess the relationships between motor dysfunction and lower limb muscle activity during gait in persons with PD; (2) Quantify the effects of physical therapy with rhythmic auditory stimulation (PT-RAS) on lower limb muscle activity during gait in persons with PD.MethodsParticipants (15 with PD) completed a 17-week intervention of PT-RAS. Gait was analyzed at baseline, after 5 weeks of supervised treatment (T5), and at a 12-week follow-up (T17). For each session, motor dysfunction was scored using the United Parkinson Disease Rating Scale, and muscle activation amplitude, modulation, variability, and asymmetry were measured for the rectus femoris, tibialis anterior, and gastrocnemius lateralis (GL). Spearman correlation analyses assessed the relationships between dysfunction and muscle activity, and mixed effect models (session × muscle) tested for intervention effects.ResultsPT-RAS was effective in decreasing motor dysfunction by an average of 23 (T5) to 36% (T17). Higher GL activity variability and bilateral asymmetry were correlated to higher dysfunction (ρ = 0.301 −0.610, p’s < 0.05) and asymmetry significantly decreased during the intervention (p < 0.05).ConclusionResults suggest that gait motor dysfunction in PD may be explained by neuromuscular control impairments of GL that go beyond simple muscle amplitude change. Physical therapy with RAS improves bilateral symmetry, but its effect on muscle variability requires future investigation.

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Effects of aging and Parkinson's disease on joint coupling, symmetry, complexity and variability of lower limb movements during gait

Abstract: These new gait assessment techniques successfully captured changes in asymmetry, variability, complexity, and joint coupling patterns. Quantitative gait assessment using these tools can be used to detect various types of gait impairments.

Cited by 23 publications

References 31 publications

Wearable Sensors Measure Ankle Joint Changes of Patients with Parkinson’s Disease before and after Acute Levodopa Challenge

Wearable Sensors Measure Ankle Joint Changes of Patients with Parkinson’s Disease before and after Acute Levodopa Challenge

Kinematic and biomimetic assessment of a hydraulic ankle/foot in level ground and camber walking

Electromyographical Gait Characteristics in Parkinson’s Disease: Effects of Combined Physical Therapy and Rhythmic Auditory Stimulation

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