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

Abstract

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.

Influences of Synchronized Metronome Training on Soccer Players’ Timing Ability, Performance Accuracy, and Lower-Limb Kinematics

“…Beckelhimer et al (2011) showed improved upper-limb functionality in two participants who had suffered stroke, and Johansson et al (2012, 2014) saw improved upper-limb movement in two different case studies of children with a different severity of cerebral palsy. An extensive number of clinical studies have also shown that fixed-tempo by the use of Rhythmic Auditory Stimulation (RAS) improves different aspects of gait timing (e.g., Thaut et al, 1996; Hove et al, 2012), and have described the effectiveness of RAS and its promising therapeutic role of improving different aspects of gait performance in patients affected by Parkinson’s disease (e.g., Thaut and Abiru, 2010; Murgia et al, 2015, 2018; Pau et al, 2016; Dalla Bella et al, 2017; Bailey et al, 2018). It’s suggested that RAS would facilitate the activity of the internal clock, thus dys-functioning in patients with Parkinson’s disease (PD), and thereby help in regulating the fluidity of muscular activation, improving coordination, and facilitating the execution of automatic movements, such as walking in PD (Murgia et al, 2018).…”

Computer-Vision Based Diagnosis of Parkinson’s Disease via Gait: A Survey

“…This type of filter removes the high-frequency components and smoothens the data thus enhancing the quality. Under low pass filter, Butterworth filter (BF) is the frequently used filter and have the unique property of flat frequency response in the passband area [70], [71]. BW filter resolves the problem of blurred edges which is often encountered in an ideal low pass filter.…”

“…The analysis revealed more postural deflects in PD with FOG subjects as compared to others and high relevance of COP than COP in PD inspection. Another study by Bailey et al [70] explored frequency and time domain features (RMS, modulation index, covariance, asymmetry index, etc.) to test the reliability of PT-RAS therapy in reducing asymmetry in PD patients.…”

NIRS-EMG for Clinical Applications: A Systematic Review

“…A comprehensive literature of EMG applications to clinical purposes can be found, spanning through a variety of investigated muscles and pathologies, in order to detect abnormal patterns with evaluation, diagnosis, and rehabilitation aims. We report on a subset of paradigmatic applications that include, but are not limited to, the assessment of lower-back pain [15,16]; the investigation of patterns for motor recruitment [17]; the analysis of walking patterns in Parkinson's [18]; gait pattern abnormality detection in multiple sclerosis [19]; applications to stroke hand rehabilitation [20]; and many others.…”