Sudden turn during walking is impaired in people with Parkinson’s disease
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The present study compared kinematic strategies for making sudden directional changes during walking between patients with Parkinson’s disease (PwPD) and age-matched controls. Ten PwPD and 10 healthy elderly were visually cued to walk straight or to turn either 30° or 60° to the left or right, at the mid-point of a 9-m walkway. Three-dimensional kinematic data recorded: (1) the onset time of body segments in response to the turning cue, and (2) step width at the first ipsilateral foot contact (IFC1) marking the beginning of turn, the subsequent contralateral foot contact (CFC), and the second ipsilateral foot contact (IFC2) marking the completion of turn. For both 30° and 60° turns, PwPD had later onset times for lateral foot displacement, and larger time lags between the onset of body CoM and the lateral foot translation than healthy subjects (P < 0.05). Furthermore, PwPD had a significantly narrower step width than healthy subjects (P < 0.05). Despite these differences, PwPD and control subjects scaled up turning speed and amplitude similarly for 30° and 60° turns. Our findings suggested that PwPD manifested specific difficulty in modifying their ongoing motor program to switch their locomotion from straight line to sideway direction, but their ability to scale movement speed and amplitude appeared to be preserved.
KeywordsParkinson’s disease Gait Walking Mobility Turning
The authors wish to acknowledge research grants given by The Hong Kong Polytechnic University (A-PF27 and G-T924), Hong Kong Parkinson’s disease Association, staff from Community Rehabilitation networks, and all research personnel: Dr. Raymond Chung, YY Wong and Man Cheung for their assistance. Our special thanks to Dr. Fay Horak for her valuable comments on the manuscript.
- Cao C, Ashton-Miller JA, Schultz AB, Alexander NB (1997) Abilities to turn suddenly while walking: effects of age, gender, and available response time. J Gerontol Med Sci 52A:M88–M93Google Scholar
- Dimitrova DM, Horak FB, Nutt JG (2004b) Postural muscle responses to multidirectional translation in patients with Parkinson’s disease. J Neurophysiol 91:491–501Google Scholar
- Huxham F, Baker R, Morris M, Iansek R (2008) Footstep adjustments used to turn during walking in Parkinson’s disease. Mov Disord. doi:10.1002/mds.21932
- Portney LG, Walkins MP (2000) Foundations of clinical research: applications to practice, 2nd edn. Appleton and Lange, StamfordGoogle Scholar
- Willems AM, Nieuwboer A, Chavret F, Desloovere K, Dom R, Rochester L, Kwakkel G, van Wegen E, Jones D (2007) Turning in Parkinson’s disease patients and controls: The effect of auditory cues. Mov Disord. doi:10.1002/mds.21445
- Winter DA (1995) A.B.C anatomy, biomechanics and control of balance during standing and walking. Waterloo Biomechanics, WaterlooGoogle Scholar