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Experimental Brain Research

, Volume 238, Issue 1, pp 139–151 | Cite as

Gait bradykinesia: difficulty in switching posture/gait measured by the anatomical y-axis vector of the sole in Parkinson’s disease

  • Tateo WarabiEmail author
  • Hiroyasu Furuyama
  • Masamichi Kato
Research Article

Abstract

This study in Parkinson’s disease examined how spatiotemporal parameters in gait bradykinesia link to difficulty in terminating posture and initiating gait locomotion. 41 idiopathic Parkinson’s disease patients and 15 age-matched healthy subjects participated in this study. After the patients fixated on a visual-fixation-target, gait was triggered by visual or vocal cue-stimulus. The LED instructed subjects to quickly achieve their own comfortable walking speed on a level floor. The posterior-anterior force of the y-axis vectors of sole relating to soleus and tibialis-anterior EMGs were examined. Step-gain was defined as the duration of the swing-phase relative that of the contralateral stance-phase. Dynamic-ratio was defined as the duration the fore-foot phase relative to that of the ipsilateral stance-phase as forward-oriented movement in each step. The pause in tonic soleus EMG was defined as the off-latency of posture (termination) and the onset of a tibialis-anterior EMG-burst as the on-latency of gait. In Parkinson’s disease, soleus off-latencies were prolonged, whereas tibialis-anterior on-latencies were less prolonged. Unsynchronized off/on-latency differences correlated with spatiotemporal parameters of dynamic-ratios, step-gains, gait-initiation, and gait speed in gait bradykinesia. Delayed EMG off-latencies correlated with prolonged motor-latencies in gait bradykinesia as delayed initial backward body-shift. A delayed and deficient initial backward body-shift of y-axis vector was linked to each difficulty in terminating posture and initiating gait, changing to random gait akinesia. Gait bradykinesia in Parkinson’s disease stemmed from unsynchronized off/on-latency EMG activities, linking to each difficulty in terminating posture and initiating gait synergic movement through an initial backward body-shift.

Keywords

Parkinson’s disease Gait bradykinesia Akinesia Motor program Off-latency 

Abbreviations

ANOVA

Analysis of variance

BS

Body-shift

DAT

Dopamine transporters

EMG

Electromyogram

GPi

Globus pallidus pars interna

GPe

Globus pallidus pars externa

H–Y

Hoehn and Yahr

LED

Light-emitting diodes

No-gap

No-gap task

SNr

Substantia nigra pars reticulate

STN

Subthalamic nucleus

Off-latency

Off-EMG latency

Off-motor program

Off-EMG latency motor program

On-latency

On-EMG latency

On-motor program

On-EMG latency motor program

Off/on-latency difference

Off/on-EMG latency difference

Off/on-latency motor program

Off/on-EMG latency motor program

Notes

Acknowledgements

The authors wish to express their gratitude to Prof. Nobuo Yanagisawa, MD PhD for his valuable comments, and Prof. Mariya A. Niendorf PhD for English language advice. We also wish to thank Mrs. Takako Takita, Eri Sugai, PT, and Kenestu Shimizu OT for skilled technical assistance with the figures and the manuscript.

Funding

The authors received no financial support for the research, authorship, or publication of this article.

Compliance with ethical standards

Conflict of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, or publication of this article.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Tateo Warabi
    • 1
    Email author
  • Hiroyasu Furuyama
    • 1
  • Masamichi Kato
    • 1
  1. 1.Clinical Brain Research Laboratory, Department of NeurologyToyokura Memorial Hall, Sapporo Yamanoue HospitalSapporoJapan

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