Dopamine replacement therapy normalizes reactive step length to postural perturbations in Parkinson?s disease

被引:4
作者
Herbers, Cara [1 ]
Schroeder, Joseph [2 ]
Lu, Chiahao [3 ]
Geng, Helen [2 ]
Zhang, Raymond [2 ]
Mehregan, Jessica [2 ]
Malakowsky, Kada [2 ]
Erdman, Arthur [1 ]
Johnson, Matthew D. [2 ]
Cooper, Scott E. [3 ]
机构
[1] Univ Minnesota, Dept Mech Engn, Minneapolis, MN 55455 USA
[2] Univ Minnesota, Dept Biomed Engn, Minneapolis, MN 55455 USA
[3] Univ Minnesota, Dept Neurol, Minneapolis, MN 55455 USA
基金
美国国家科学基金会; 美国国家卫生研究院;
关键词
Postural Instability; Balance; Step Length; Levodopa; Parkinson?s disease; PULL TEST; BALANCE; PATHOPHYSIOLOGY; INSTABILITY; MEDICATION; BACKWARD; LEVODOPA; GAIT;
D O I
10.1016/j.gaitpost.2023.01.022
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Background: Postural instability is one of the most disabling motor symptoms of Parkinson's disease (PD) given its association with falls and loss of independence. Previous studies have assessed biomechanical measures of reactive stepping in response to perturbations, showing that individuals with PD exhibit inadequate postural responses to regain balance.Research question: Does dopamine replacement therapy normalize step length in response to balance perturbations?Methods: In this study, we estimated reactive step length, to a postural perturbation, retrospectively from a dataset of frontal plane video using 2D motion tracking and direct linear transform methods. We compared two perturbation methods: support surface translation and shoulder pull (the clinical standard) in 14 individuals with PD and 13 without PD (on and off medication), with and without partial body weight support (BWS). The primary outcome was the length of the first step taken to regain balance after the perturbation analyzed with mixed effects ANOVA, with post hoc analysis of anteroposterior (AP) and mediolateral (ML) components. Results: PD OFF medication exhibited shorter reactive step length compared to PD ON and compared to control groups for the surface translation perturbations, but no significant difference was observed for the shoulder pull perturbations.Significance: Dopamine replacement therapy affects step length in response to perturbation more robustly for surface translations than for a pull by the shoulders.
引用
收藏
页码:95 / 100
页数:6
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