Abstract
Previous research has found ankle proprioception to be impaired in people with Parkinson's disease (PD). However, the relationship between ankle proprioception and functional mobility in people with PD has not been fully investigated. The purpose of this study was to examine whether ankle proprioception is related to the functional mobility of people with PD. Forty-two participants with mild to moderate PD volunteered. Ankle proprioceptive acuity was measured in standing, by using active movement extent discrimination assessment (AMEDA). Functional mobility measures included the timed-up-and-go test (TUG), 30 s sit-to-stand test (30s-STS) and 10-meter walking test (10MWT). Step length and step cadence were recorded during the 10MWT. No significant correlation was found between ankle proprioceptive discrimination scores and any mobility performance measure in people with PD (−0.20<r<0.04, all p > 0.05). However, ankle proprioception scores were significantly correlated with step length (r = 0.38, p < 0.05) and step cadence (r = −0.30, p < 0.05), and were significantly and negatively correlated with the stage of modified Hoehn and Yahr (rho = −0.53, p < 0.01). The lack of relationship between ankle proprioceptive acuity and functional mobility in PD suggests that people with PD may be more limited by reduced sensorimotor integration or may rely more on other sensory input, rather than ankle proprioception, to achieve functional mobility, a finding consistent with sensory reweighting theory. In addition, poorer ankle proprioceptive acuity was associated with decreased step length and increased step cadence, suggesting that the shuffling gait observed in PD may be related to impaired ankle proprioception, which has important clinical implications for gait retraining in people with PD. Given that ankle proprioception was significantly and negatively correlated with the stage of modified Hoehn and Yahr, it may warrant being used as an objective biomarker to monitor the progression of PD.
Highlights
Parkinson’s disease (PD) is the second most common neurodegenerative disease and may impair patients’ functional mobility [1,2,3]
There are various physical and psychological factors that may affect the mobility of people with PD [5], decreased functional mobility in people with PD has been attributed to abnormal neural activity in the basal ganglia that may significantly decrease the precision of motor control, in two ways [7, 8]
No significant correlation was found between ankle proprioceptive acuity scores and any mobility performance measure in people with PD, ankle proprioception was significantly correlated with step length and step cadence on the 10-meter walking test (10 MWT)
Summary
Parkinson’s disease (PD) is the second most common neurodegenerative disease and may impair patients’ functional mobility [1,2,3]. There are various physical and psychological factors that may affect the mobility of people with PD [5], decreased functional mobility in people with PD has been attributed to abnormal neural activity in the basal ganglia that may significantly decrease the precision of motor control, in two ways [7, 8]. Because one-third of the neurons in the basal have proprioceptive fields basal ganglia dysfunction may reduce the quality of afferent proprioceptive information, which may result in poor functional mobility in people with PD. Impaired integration of available sensorimotor information could negatively affect functional mobility of people with PD. The neural mechanisms underlying impaired functional mobility in people with PD are still unclear
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