Article

OBJECTIVE: To determine whether haptic (touch and proprioception) cues from
touching a moving handrail while walking can ameliorate the gait symptoms of
Parkinson disease (PD), such as slowness and small stride length. DESIGN:
Nonrandomized, controlled before-after trial. SETTING: Physical therapy clinic.
PARTICIPANTS: People with PD (n=16) and healthy age-matched control subjects
(n=16) with no neurologic disorders volunteered. No participants withdrew.
INTERVENTIONS: We compared gait using a moving handrail as a novel assistive aid
(speed self-selected) versus a banister and unassisted walking. Participants with
PD were tested on and off dopaminergic medication. MAIN OUTCOME MEASURES: Mean
gait speed, stride length, stride duration, double-support duration, and
medial-lateral excursion. RESULTS: With the moving handrail, participants with PD
increased gait speed relative to unassisted gait by 16% (.166m/s, P=.009, d=.76;
95% confidence interval [CI], .054-.278m/s) and increased stride length by 10%
(.053m, P=.022, d=.37; 95% CI, .009-.097m) without significantly changing stride
or double-support duration. The banister reduced speed versus unassisted gait by
11% (-.097m/s, P=.040, d=.40; 95% CI, .002-.193m/s) and reduced stride length by
8% (.32m, P=.004, d=.26; 95% CI, .010-.054m), whereas it increased stride
duration by 3% (.023s, P=.022, d=.21; 95% CI, .004-.041s) and double-support
duration by 35% (.044s, P=.031, d=.58; 95% CI, .005-.083s). All medication x
condition interactions were P>.05. CONCLUSIONS: Using haptic speed cues from the
moving handrail, people with PD walked faster by spontaneously (ie, without
specific instruction) increasing stride length without altering cadence;
banisters slowed gait. Haptic cues from the moving handrail can be used by people
with PD to engage biomechanical and neural mechanisms for interpreting tactile
and proprioception changes related to gait speed to control gait better than
static cues afforded by banisters.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS