Locomotor adaptation and locomotor adaptive learning in Parkinson’s disease and normal aging

Abstract

Objective Locomotor adaptation enables safe, efficient navigation among changing environments. We investigated how healthy young (HYA) and older (HOA) adults and persons with Parkinson’s disease (PD) adapt to walking on a split-belt treadmill, retain adapted gait parameters during re-adaptation, and store aftereffects to conventional treadmill walking. Methods Thirteen PD, fifteen HYA, and fifteen HOA walked on a split-belt treadmill for ten minutes with one leg twice as fast as the other. Participants later re-adapted to the same conditions to assess retention of the split-belt gait pattern. After re-adaptation, we assessed aftereffects of this pattern during conventional treadmill walking. Results Persons with PD exhibited step length asymmetry throughout many adaptation and adaptive learning conditions. Early adaptation was similar across groups, though HYA and HOA continued to adapt into late adaptation while PD did not. Despite pervasive step length asymmetry among conditions which were symmetric in HYA and HOA, persons with PD demonstrated significant step length aftereffects during conventional treadmill walking after split-belt walking. Conclusions Though they may exhibit a default asymmetry under various walking conditions, persons with PD can adapt and store new walking patterns. Significance Locomotor adaptation therapy may be effective in ameliorating asymmetric gait deficits in persons with PD.

Effects of dopaminergic therapy on locomotor adaptation and adaptive learning in persons with Parkinson's disease

“…Thus, regardless of medication state, the participants adapted step length asymmetry from EARLY to LATE in similar fashion to previous studies of persons with PD on medication [8] and healthy young and older adults [13] (Figure 3). The order in which the sessions were performed appears to have little effect on any of the conditions, with perhaps the exception of EARLY (Figure 4; statistical analyses comparing the participants tested while ON meds first to those tested while OFF meds first were not performed due to sample size limitations of n=5 in each subgroup).…”

“…We have previously shown that an acute bout of SBT walking can at least temporarily alter step length asymmetry in persons with PD [8]. While not all persons with PD exhibit significant gait asymmetry, those affected by asymmetric walking patterns may benefit from SBT training.…”

“…Previous work on SBT walking in PD showed that optimally medicated persons with PD adapted step lengths toward an asymmetric asymptote which paralleled their baseline asymmetry while age-matched controls adapted to a relatively symmetric state [8]. Impairments in the storage of aftereffects or savings were not observed.…”

“…While some treatments induce modest gait improvement, no interventions exist which wholly restore gait performance in PD. Recent research has investigated locomotor adaptation and adaptive learning processes within the context of gait rehabilitation for populations characterized by gait asymmetry, including persons post-stroke [4,5] and with PD [6–8]. Certainly, developing a better understanding of the abilities of persons with PD to adapt and store gait patterns could have significant impact on the design of gait rehabilitation paradigms and further insight into the neural substrates facilitating these processes.…”

Wearable sensor network to study laterality of brain functions

“…By making possible monitoring of subjects in more natural environments wearable system may provide more comprehensive information on mechanisms of asymmetry or symmetry between right and brain functions. This information may improve performance in sport [14], adaptive behavioral decisions that are based on lateralized skills [2], as well as may help to improve effectiveness of some healthcare interventions [15].…”