Article

OBJECTIVE: To characterize anticipatory postural adjustments (APAs) across a
variety of step initiation tasks in people with Parkinson disease (PD) and
healthy subjects. DESIGN: Cross-sectional study. Step initiation was analyzed
during self-initiated gait, perceptual cued gait, and compensatory forward
stepping after platform perturbation. People with PD were assessed on and off
levodopa. SETTING: University research laboratory. PARTICIPANTS: People (N=31)
with PD (n=19) and healthy aged-matched subjects (n=12). INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Mediolateral (ML) size of APAs (calculated
from center of pressure recordings), step kinematics, and body alignment.
RESULTS: With respect to self-initiated gait, the ML size of APAs was
significantly larger during the cued condition and significantly smaller during
the compensatory condition (P<.001). Healthy subjects and patients with PD did
not differ in body alignment during the stance phase prior to stepping. No
significant group effect was found for ML size of APAs between healthy subjects
and patients with PD. However, the reduction in APA size from cued to
compensatory stepping was significantly less pronounced in PD off medication
compared with healthy subjects, as indicated by a significant group by condition
interaction effect (P<.01). No significant differences were found comparing
patients with PD on and off medications. CONCLUSIONS: Specific stepping
conditions had a significant effect on the preparation and execution of step
initiation. Therefore, APA size should be interpreted with respect to the
specific stepping condition. Across-task changes in people with PD were less
pronounced compared with healthy subjects. Antiparkinsonian medication did not
significantly improve step initiation in this mildly affected PD cohort.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS