Sequence and onset of whole-body coordination when turning in response to a visual trigger: Comparing people with Parkinson's disease and healthy adults

Ashburn, Ann; Kampshoff, Caroline S.; Burnett, Malcolm; Stack, Emma; Pickering, RM; Verheyden, Geert

doi:10.1016/j.gaitpost.2013.07.128

Cited by 18 publications

(30 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Bottom-up control, would be mainly related to equilibrium maintenance and thus more severely affect people with PD, owing to the reduced capacity to generate ground reaction forces [48] as a result of an impaired extensor muscle activity and ankle strategy. This is reflected in the findings of Ashburn et al [45] and Akram et al [9] showing the greatest difference in the onset latency of segments to a turning cue between people with PD and healthy controls in the lower body segments (pelvis and feet). A resultant delayed co-ordination with top-down control may arise [6], which may also be influenced by the difficulty people with PD experience in achieving dual motor tasks simultaneously [2].…”

Section: Turning In Pd 1385mentioning

confidence: 91%

“…(ii) Axial deficit -Segment coordination and timing When turning, people with PD have consistently shown linked movement of the head, trunk and pelvis in a characteristic ''enbloc'' appearance [6,8,17,22,27,29,45]. In comparison, healthy young controls demonstrate a reciprocal oscillating pattern of movement, with movement of one segment resulting in co-ordinated counterbalancing in the next [16,20], also retained in healthy older adults during walking turns [17,22].…”

Section: Turning In Pd 1385mentioning

confidence: 99%

See 1 more Smart Citation

A narrative review of turning deficits in people with Parkinson’s disease

Hulbert

Ashburn

Robert

et al. 2014

Disability and Rehabilitation

View full text Add to dashboard Cite

Specific movement deficits in turning in people with PD can be categorised into axial and perpendicular deficits. Synthesis of the literature suggests the possibility of axial deficits driving secondary responses in the perpendicular segments. This should be explored when designing rehabilitation aimed at improving turning performance, as current therapy guidelines focus on exercises emphasising perpendicular aspects. Implications for Rehabilitation Turning performance is compromised in people with PD, which can lead to significant disability, falls and loss of function. Specific movement deficits can be categorised into perpendicular deficits (taking more steps and shorter steps and an altered turn strategy) and axial deficits (segment rigidity, altered segment co-ordination and timing, reduced segment rotation and the effects of altered posture). Axial deficits may drive secondary responses in the perpendicular segments during turning in people with PD. Therefore, specific focus should be made to the rehabilitation of the axial deficits alongside those of the perpendicular body segments in the design of multi-modal treatment strategies to improve turning performance.

show abstract

Section: Turning In Pd 1385mentioning

confidence: 91%

Section: Turning In Pd 1385mentioning

confidence: 99%

A narrative review of turning deficits in people with Parkinson’s disease

Hulbert

Ashburn

Robert

et al. 2014

Disability and Rehabilitation

View full text Add to dashboard Cite

show abstract

“…The sequential eyes-head-trunk-feet movement observed during turning in healthy adults is lost in PD patients; they turn “en bloc”, with a more simultaneous onset of eyes, head, trunk and leg movement [34-37]. Speed of turning in people with PD is related to axial tone in the neck, but not trunk or hips [38].…”

Section: Gait Deficits In Parkinson's Diseasementioning

confidence: 99%

Pharmacological treatment in Parkinson's disease: Effects on gait

Smulders

Dale

Carlson‐Kuhta

et al. 2016

Parkinsonism & Related Disorders

139

129

View full text Add to dashboard Cite

Gait impairments are a hallmark of Parkinson's disease (PD), both as an early symptom and an important cause of disability later in the disease course. Although levodopa has been shown to improve gait speed and step length, the effect of dopamine replacement therapy on other aspects of gait is less well understood. In fact, falls are not reduced and some aspects of postural instability during gait are unresponsive to dopaminergic treatment. Moreover, many medications, other than dopaminergic agents, can benefit or impair gait in people with PD. We review the effects of pharmacological interventions used in PD on gait, discriminating, whenever possible, among effects on four components of everyday mobility: straight walking, gait initiation, turning, gait adaptability. Additionally, we summarize the effects on freezing of gait. There is substantial evidence for improvement of spatial characteristics of simple, straight-ahead gait with levodopa and levodopa-enhancing drugs. Recent work suggests that drugs aiming to enhance the acetylcholine system might improve gait stability measures. There is a lack of well-designed studies to evaluate effects on more complex, but highly relevant walking abilities such as turning and flexible adjustments of gait. Finally, paucity in the literature exists on detrimental effects of drugs used in PD that are known to worsen gait and postural stability in the elderly population.

show abstract

“…Turning requires the central nervous system to coordinate body re-orientation towards a new travel direction while continuing with the ongoing step cycle and maintaining medio-lateral stability 4 , 5 . Laboratory studies of turning in people with PD have reported reduced speed, increased turning duration, increased number of steps 1 , 6 , 7 , a narrower base of support 8 , and impaired segmental coordination of rotation (“en-bloc”) 4 , 5 , 9 , 10 . Turning has also been found as one of the strongest motor tasks to elicit Freezing of Gait (FoG) in the laboratory 11 – 14 .…”

Section: Introductionmentioning

confidence: 99%

Assessment of the ability of open- and closed-loop cueing to improve turning and freezing in people with Parkinson’s disease

Mancini

Smulders

Harker

et al. 2018

Sci Rep

109

View full text Add to dashboard Cite

Turning impairments are common in Parkinson’s disease (PD) and can elicit freezing of gait (FoG). Extensive examination of open-loop cueing interventions has demonstrated that they can ameliorate gait deficits in PD; less is known about efficacy to improve turning. Here, we investigate the immediate effectiveness of open- and closed-loop cueing in improving turning characteristics in people with PD. Twenty-five subjects with and 18 subjects without FoG participated in the study. Subjects turned in place for one minute under single- and dual-task for 3 randomized conditions: (i) Baseline; (ii) Turning to the beat of a metronome (open-loop); and (iii) Turning with phase-dependent tactile biofeedback (closed-loop). Objective measures of freezing, such as % time spent freezing and FoG-ratio, significantly improved when turning with both open-loop and closed-loop cueing compared to baseline. Dual-tasking did not worsen FoG in freezers, but significantly slowed down turns in both groups. Both cueing modalities significantly improved turning smoothness in both groups, but reduced turning velocity and number of turns compared to baseline. Both open and closed-loop cueing markedly improved turning in people with PD. These preliminary observations warrant further exploration of vibrotactile closed-loop cueing to improve mobility in everyday life.

show abstract

Sequence and onset of whole-body coordination when turning in response to a visual trigger: Comparing people with Parkinson's disease and healthy adults

Cited by 18 publications

References 29 publications

A narrative review of turning deficits in people with Parkinson’s disease

A narrative review of turning deficits in people with Parkinson’s disease

Pharmacological treatment in Parkinson's disease: Effects on gait

Assessment of the ability of open- and closed-loop cueing to improve turning and freezing in people with Parkinson’s disease

Contact Info

Product

Resources

About