Article

Falls are common in idiopathic Parkinson's disease (PD) and
frequently occur when walking and crossing obstacles. OBJECTIVE: To determine
whether people with mild to moderately severe PD have abnormal centre of mass
(CoM) motion in response to the perturbations of level-ground walking and
obstacle crossing. METHOD: Mediolateral excursion and velocity of the CoM were
measured using three-dimensional motion analysis and force platforms in 20 people
with mild to moderately severe PD at the peak dose of their PD medication, and 20
age and sex matched healthy control participants. RESULTS: People with PD had
greater sideways sway than healthy older adults when walking, particularly when
walking over obstacles. People with PD also maintained their CoM more medial to
their stance foot throughout the swing phase of gait compared to controls. The
severity of motor symptoms in people with PD, measured using the UPDRS-III, was
associated with faster sideways CoM motion but not increased CoM excursions.
CONCLUSIONS: Environmental hazards, such as ground-based obstacles, may
accentuate postural instability in people with PD. Increased mediolateral sway
might be due to impaired postural responses or kinematic compensations to
increase foot clearance. Fall prevention programs could benefit from inclusion of
components educating people with PD about the risks associated with obstacle
crossing when walking.
CI - Copyright (c) 2013 Elsevier B.V. All rights reserved.

Langue : ANGLAIS