Article

Bradykinesia is a prominent problem for persons with Parkinson's disease (PD) and
has been studied extensively with upper extremity tasks; however there is a lack
of research examining bradykinesia in targeted lower extremity tasks related to
mobility. Navigating steps and curbs are challenging tasks for older adults and
neurologically impaired and thus utilizing these behaviors provides ecological
validity to the study of bradykinesia. Herein we assess differences in step
negotiation performance between individuals with PD and aged matched older
adults. Three-dimensional kinematics and ground reaction forces were collected
while 12 participants with PD and 12 older adults performed a single step up onto
a platform. Persons with PD spent a significantly greater amount of time in the
heel lift phase (P=0.0003, d=1.80). Peak vertical foot velocity of the lead foot
was also significantly less in PD (P=0.02, d=1.05). Lastly, persons with PD
displayed reduced sagittal hip and knee range of motion during the trail step
(P=0.01, d=1.20 and P=0.02, d=1.05, respectively). Parkinson's participants
exhibited slight decrement in step negotiation execution. Increased step time and
decreased foot velocity and range of motion were attributes associated with
Parkinson's step negotiation performance. Contrary to our hypothesis, in many
comparisons, persons with PD during their best medicated state performed
comparable to older adults, indicative of successful pharmacotherapy.
Rehabilitation efforts can seek to improve performance in motor control tasks
such as step negotiation, by restoring the relationship between perceived and
actual motor output and enhancing muscle coordination and output as well as
ranges of motion.
CI - Copyright (c) 2017. Published by Elsevier B.V.

Langue : ANGLAIS