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Control of the Motions of the Body’s Center of Mass and End-Points of the Lower Limbs in Patients with Mild Parkinson’s Disease During Obstacle-Crossing

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Abstract

Neuromuscular impairments in Parkinson’s disease (PD) alter the mechanics and control of the body, leading to an increased risk of falling during more challenging functional tasks such as obstacle-crossing. However, little is known about these changes. The current study aimed to bridge the gap by quantifying the motion of the body’s center of mass (COM) relative to the center of pressure (COP) in terms of COM-COP inclination angles (IA) and their rate of change (RCIA) in fifteen older adults with mild PD and fifteen healthy controls when crossing obstacles of heights of 10, 20 and 30% leg length. There were no between-group differences for either the leading or trailing toe clearances (p > 0.05). With the unaffected limb leading, the PD subjects significantly increased the crossing sagittal and frontal IA, crossing sagittal RCIA, the peak RCIA, and average sagittal and frontal RCIAs during double-limb support for all obstacle heights when compared to those with the affected limb leading and those of the Controls (p < 0.05). The poor balance control in the mediolateral direction during obstacle-crossing in PD indicated an increased risk of falling. The differences in the crossing patterns between leading with the affected or unaffected limb suggest that patients with PD should lead with the affected limb when crossing obstacles. The current findings suggest that early dynamic balance training is important in the management of patients with PD.

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Acknowledgements

The authors are grateful for the financial support from the National Science Council, Taiwan (NSC 98-2320-B-002-005-MY3). The assistance in data collection provided by Drs Chu-Fen Chang and Sheng-Chang Chen is also greatly appreciated.

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Author notes

  1. Yen-Hung Liu and Mei-Ying Kuo authors have contributed equally to this study.

Authors and Affiliations

  1. Institute of Biomedical Engineering, National Taiwan University, No. 1, Sec. 1, Jen-Ai Road, 100, Taipei, Taiwan, ROC

    Yen-Hung Liu, Zhi-You Chen & Tung-Wu Lu

  2. Department of Physical Therapy, Tzu-Hui Institute of Technology, 926, Pingtung, Taiwan, ROC

    Yen-Hung Liu

  3. Department of Physical Therapy, China Medical University, 404, Taichung, Taiwan, ROC

    Mei-Ying Kuo

  4. Department of Neurology, National Taiwan University Hospital, 100, Taipei, Taiwan, ROC

    Ruey-Meei Wu

  5. Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, 100, Taipei, Taiwan, ROC

    Tung-Wu Lu

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  1. Yen-Hung Liu
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Correspondence to Tung-Wu Lu.

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Liu, YH., Kuo, MY., Wu, RM. et al. Control of the Motions of the Body’s Center of Mass and End-Points of the Lower Limbs in Patients with Mild Parkinson’s Disease During Obstacle-Crossing. J. Med. Biol. Eng. 38, 534–543 (2018). https://doi.org/10.1007/s40846-017-0329-y

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  • DOI: https://doi.org/10.1007/s40846-017-0329-y

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