Article

The pathophysiology behind gait impairments seen in Parkinson's
disease (PD), in particular freezing of gait (FOG), is not fully understood. Here
we study the interplay between several gait features related to FOG during
different split-belt treadmill (SBTM) conditions. METHODS: We investigated the
spatiotemporal properties, the phenomenon of sequence effect and the inter-limb
symmetry and temporal coordination of gait during different split-belt conditions
in 20 patients with advanced Parkinson's disease and different severities of
freezing. Subjects were tested in four belt configurations: tied, split while
reducing the velocity of leg with the shorter (worst side reduction, WSR) and
longer (best side reduction, BSR) step length, and tied again to measure the
after-effect. RESULTS: We found that in spite of an improvement of spatial
symmetry, the BSR led to a worsening of coordination
(i.e. the left-right
anti-phased stepping) and an increased sequence effect
(i.e. progressive
shortening of the step length). By contrast, in spite of a worsened spatial
symmetry, WSR improved inter-limbs coordination and reduced the sequence effect.
After prolonged split-belt walking gait was differently modulated according to
the reduction of the best or worst leg velocity: BSR led to positive after
effects in symmetry, bilateral coordination and sequence effect. CONCLUSIONS:
These findings support the hypothesis that the irregularity of inter-limb
coordination and defective amplitude generation leading to sequence effect might
be coupled and result from the same maladaptive motor behavior. Furthermore, our
results show that SBTM can be an effective tool to improve parkinsonian gait.
CI - Copyright (c) 2016 Elsevier B.V. All rights reserved.

Langue : ANGLAIS