Abstract
The evidence of the responsiveness of dopaminergic medication on gait in patients with Parkinson’s disease is contradicting. This could be due to differences in complexity of the context gait was in performed. This study analysed the effect of dopaminergic medication on arm swing, an important movement during walking, in different contexts. Forty-five patients with Parkinson’s disease were measured when walking at preferred speed, fast speed, and dual-tasking conditions in both OFF and ON medication states. At preferred, and even more at fast speed, arm swing improved with medication. However, during dual-tasking, there were only small or even negative effects of medication on arm swing. Assuming that dual-task walking most closely reflects real-life situations, the results suggest that the effect of dopaminergic medication on mobility-relevant movements, such as arm swing, might be small in everyday conditions. This should motivate further studies to look at medication effects on mobility in Parkinson’s disease, as it could have highly relevant implications for Parkinson’s disease treatment and counselling.
Highlights
Dopaminergic medication is the most common treatment for people with Parkinson’s disease
Changes in arm swing with dopaminergic medication
This study shows that the effect of dopaminergic medication on arm swing is substantially influenced by the context in which patients with Parkinson’s disease walk
Summary
Dopaminergic medication is the most common treatment for people with Parkinson’s disease. We hypothesize that at least some of the above-mentioned contradicting results may be explained by differences in the context where the respective walking task is performed This hypothesis is, at least indirectly, supported by studies that found an effect of task complexity on the effect of medication on certain gait parameters (e.g., gait speed[18] and stride time variability[19]). Two studies reported a change in the difference of walking parameters between Parkinson’s disease and controls, depending on the walking paradigm (between preferred and fast walking condition: gait speed, swing velocity, step time, and swing time; between preferred and dual-task condition: stride length and percentage swing time[20,21]). Arm swing amplitude and angular velocity increase with medication[5,16,30]
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