Transitional Locomotor Tasks in People With Mild to Moderate Parkinson's Disease.

Anna Kamieniarz,Grzegorz Juras,Justyna Michalska,Agnieszka Krzak-Kubica,Anna Akbaş,Wojciech Marszałek,Monika Rudzińska-Bar,Kajetan J Słomka

doi:10.3389/fneur.2020.00405

Abstract

Background: People with Parkinson's disease (PD) exhibit deficits in maintaining balance both during quiet standing and during walking, turning, standing up from sitting, and step initiation.Objective: The purpose of this study was to examine balance disorders during a transitional task under different conditions in participants with PD.Methods: The research was conducted on 15 PD-II (mild) and 15 PD-III (moderate) individuals (H&Y II-III stage) and 30 healthy elderly. The transitional task was measured on two force platforms (A and B). The procedure consisted of three phases: (1) quiet standing on platform A, (2) crossing to platform B, and (3) quiet standing on platform B, each until measurements were completed. There were four conditions: crossing without an obstacle, crossing with an obstacle, and walking up and down the step.Results: There were no significant differences between mild PD individuals and healthy elderly during quiet standing before the transitional task and after completing the task. The temporal aspects describing the different transitional tasks were comparable between mild PD and healthy subjects. Moderate PD participants presented a significantly higher COP velocity after the transitional task compared to the healthy older adults (p < 0.05). Additionally, the moderate PD group showed significantly higher values for transit time relative to healthy subjects during the transitional task in all conditions (p < 0.05).Conclusions: Disease severity affects the temporal aspects of different transitional tasks in people with PD. The procedure of completing a transitional task under different conditions allowed differences between moderate and mild PD stages and healthy subjects to be observed.

Highlights

Alterations in postural control strategies in Parkinson’s disease have been typically investigated during standing tasks [1,2,3,4]
The Parkinson’s disease (PD)-II and PD-III groups were different with respect to age, so the control subjects were divided on the basis of age into two groups: control group Control group A (CA), healthy subjects age matched to group PD-II, and control group Control group B (CB), healthy subjects age matched to group PD-III
We investigated a transitional task under different conditions in people with mild and moderate PD

Summary

Introduction

Alterations in postural control strategies in Parkinson’s disease have been typically investigated during standing tasks [1,2,3,4]. There is evidence that people with PD present impaired postural control during gait with an additional task [17, 22, 23]; a complex motor activity from daily life, such as crossing an obstacle or negotiating stairs, may be hazardous for people with PD. There is evidence that both the anticipatory postural adjustment (APA) and the stepping phase of GI are impaired in PD [26] This is mainly due to akinesia, reported as slowness and poverty of movement [27]. These functional limitations might increase the risk of falls during more challenging daily activities as a consequence of impaired transition from the double- to single-support phase [28]. People with Parkinson’s disease (PD) exhibit deficits in maintaining balance both during quiet standing and during walking, turning, standing up from sitting, and step initiation

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Results

Discussion

Conclusion