Article

The trunk plays a critical role in attenuating movement-related forces
that threaten to challenge the body's postural control system. For people with
Parkinson's disease (PD), disease progression often leads to dopamine-resistant
axial symptoms, which impair trunk control and increase falls risk. Objective
This prospective study aimed to evaluate the relationship between impaired trunk
muscle function, segmental coordination, and future falls in people with PD.
Methods Seventy-nine PD patients and 82 age-matched controls completed clinical
assessments and questionnaires to establish their medical history, symptom
severity, balance confidence, and falls history. Gait characteristics and trunk
muscle activity were assessed using 3-dimensional motion analysis and surface
electromyography. The incidence, cause, and consequence of any falls experienced
over the next 12 months were recorded and indicated that 48 PD and 29 control
participants fell at least once during this time. Results PD fallers had greater
peak and baseline lumbar multifidus (LMF) and thoracic erector spinae (TES)
activations than control fallers and nonfallers. Analysis of covariance indicated
that the higher LMF activity was attributable to the stooped posture adopted by
PD fallers, but TES activity was independent of medication use, symptom severity,
and trunk orientation. Furthermore, greater LMF and TES baseline activity
contributed to increasing lateral head, trunk, and pelvis movements in PD fallers
but not nonfallers or controls. Conclusions The results provide evidence of
neuromuscular deficits for PD fallers that are independent of medications,
symptom severity, and posture and contribute to impaired head, trunk, and pelvis
control associated with falls in this population.
CI - (c) The Author(s) 2016.

Langue : ANGLAIS