Walking and turning is a movement that places individuals with Parkinson’s disease (PD) at increased risk for fall-related injury. However, turning is an essential movement in activities of daily living, making up to 45 % of the total steps taken in a given day. Hypotheses regarding how turning is controlled suggest an essential role of anticipatory eye movements to provide feedforward information for body coordination. However, little research has investigated control of turning in individuals with PD with specific consideration for eye movements. The purpose of this study was to examine eye movement behavior and body segment coordination in individuals with PD during walking turns. Three experimental groups, a group of individuals with PD, a group of healthy young adults (YAC), and a group of healthy older adults (OAC), performed walking and turning tasks under two visual conditions: free gaze and fixed gaze. Whole-body motion capture and eye tracking characterized body segment coordination and eye movement behavior during walking trials. Statistical analysis revealed significant main effects of group (PD, YAC, and OAC) and visual condition (free and fixed gaze) on timing of segment rotation and horizontal eye movement. Within group comparisons, revealed timing of eye and head movement was significantly different between the free and fixed gaze conditions for YAC (p < 0.001) and OAC (p < 0.05), but not for the PD group (p > 0.05). In addition, while intersegment timings (reflecting segment coordination) were significantly different for YAC and OAC during free gaze (p < 0.05), they were not significantly different in PD. These results suggest individuals with PD do not make anticipatory eye and head movements ahead of turning and that this may result in altered segment coordination during turning. As such, eye movements may be an important addition to training programs for those with PD, possibly promoting better coordination during turning and potentially reducing the risk of falls.
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The authors are thankful to the participants who volunteered for the study and the undergraduate students who assisted in data collection.
All authors contributed substantially to the project. V. Ambati and R. Reed-Jones developed and executed the project, analyzed the data and wrote the manuscript. N. Murray and F. Saucedo contributed to the design, execution, collection, and analysis of the data. D. Powell contributed to the analysis of the data and writing and reviewing of the manuscript.
Ambati VNP, Murray NG, Saucedo F, Powell DW, Reed-Jones RJ (2013) Constraining eye movement when redirecting walking trajectories alters turning control in healthy young adults. Exp Brain Res 226:549–556. doi:10.1007/s00221-013-3466-8CrossRefGoogle Scholar
Bloem BR, Grimbergen YA, Cramer M, Willemsen M, Zwinderman AH (2001) Prospective assessment of falls in Parkinson’s disease. J Neurol 248:950–958CrossRefPubMedGoogle Scholar
Bloem BR, Hausdorff JM, Visser JE, Giladi N (2004) Falls and freezing of gait in Parkinson’s disease: a review of two interconnected, episodic phenomena. Mov Disord 19:871–884. doi:10.1002/mds.20115CrossRefPubMedGoogle Scholar
Comoli E, Coizet V, Boyes J et al (2003) A direct projection from superior colliculus to substantia nigra for detecting salient visual events. Nat Neurosci 6:974–980. doi:10.1038/nn1113CrossRefPubMedGoogle Scholar
Franzen E, Paquette C, Gurfinkel VS, Cordo PJ, Nutt JG, Horak FB (2009) Reduced performance in balance, walking and turning tasks is associated with increased neck tone in Parkinson’s disease. Exp Neurol 219:430–438CrossRefPubMedPubMedCentralGoogle Scholar
Giladi N, McMahon D, Przedborski S, Flaster E, Guillory S, Kostic V, Fahn S (1992) Motor blocks in Parkinson’s disease. Neurology 42:333–339CrossRefPubMedGoogle Scholar
Hollands M, Sorensen K, Patla A (2001) Effects of head immobilization on the coordination and control of head and body reorientation and translation during steering. Exp Brain Res 140(2):223–233. doi:10.1007/s002210100811CrossRefPubMedGoogle Scholar
Mellone S, Mancini M, King LA, Horak FB, Chiari L (2016) The quality of turning in Parkinson’s disease: a compensatory strategy to prevent postural instability? J Neuroeng Rehabil 13(1):1CrossRefGoogle Scholar
Patla AE, Prentice SD, Robinson C, Neufeld J (1991) Visual control of locomotion: strategies for changing direction and for going over obstacles. J Exp Psychol Hum Percept Perform 17:603–634CrossRefPubMedGoogle Scholar
Patla AE, Adkin A, Ballard T (1999) Online steering: coordination and control of body center of mass, head and body reorientation. Exp Brain Res 129:629–634CrossRefPubMedGoogle Scholar
Stack E, Ashburn A (1999) Fall events described by people with Parkinson’s disease: implications for clinical interviewing and the research agenda. Physiother Res Int 4:190–200CrossRefPubMedGoogle Scholar
Zampieri C, Di Fabio RP (2009) Improvement of gaze control after balance and eye movement training in patients with progressive supranuclear palsy: a quasi-randomized controlled trial. Arch Phys Med Rehabil 90:263–270. doi:10.1016/j.apmr.2008.07.024CrossRefPubMedGoogle Scholar