Article

OBJECTIVE: To evaluate the effect of imposed faster and slower walking speeds on
postural stability in people with Parkinson disease (PD).
DESIGN: Cross-sectional
cohort study. SETTING: General community. PARTICIPANTS: Patients with PD (n=84;
51 with a falls history; 33 without) and age-matched controls (n=82) were invited
to participate via neurology clinics and preexisting databases. Of those
contacted, 99 did not respond (PD=36; controls=63) and 27 were not interested
(PD=18; controls=9). After screening, a further 10 patients were excluded; 5 had
deep brain stimulation surgery and 5 could not accommodate to the treadmill. The
remaining patients (N=30) completed all assessments and were subdivided into PD
fallers (n=10), PD nonfallers (n=10), and age-matched controls (n=10) based on
falls history. INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES:
Three-dimensional accelerometers assessed head and trunk accelerations and
allowed calculation of harmonic ratios and root mean square (RMS) accelerations
to assess segment control and movement amplitude. RESULTS: Symptom severity,
balance confidence, and medical history were established before participants
walked on a treadmill at 70%, 100%, and 130% of their preferred speed. Head and
trunk control was lower for PD fallers than PD nonfallers and older adults.
Significant interactions indicated head and trunk control increased with speed
for PD nonfallers and older adults, but did not improve at faster speeds for PD
fallers. Vertical head and trunk accelerations increased with walking speed for
PD nonfallers and older adults, while the PD fallers demonstrated greater
anteroposterior RMS accelerations compared with both other groups. CONCLUSIONS:
The results suggest that improved gait dynamics do not necessarily represent
improved walking stability, and this must be respected when rehabilitating gait
in patients with PD.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS