Harro, C.; Alderink, G.; Hickox, L.; Zeitler, D.W.; Avery, M.; Daman, C.; Laker, D. Dynamic Measures of Balance during Obstacle-Crossing in Self-Selected Gait in Individuals with Mild-to-Moderate Parkinson’s Disease. Appl. Sci.2024, 14, 1271.
Harro, C.; Alderink, G.; Hickox, L.; Zeitler, D.W.; Avery, M.; Daman, C.; Laker, D. Dynamic Measures of Balance during Obstacle-Crossing in Self-Selected Gait in Individuals with Mild-to-Moderate Parkinson’s Disease. Appl. Sci. 2024, 14, 1271.
Harro, C.; Alderink, G.; Hickox, L.; Zeitler, D.W.; Avery, M.; Daman, C.; Laker, D. Dynamic Measures of Balance during Obstacle-Crossing in Self-Selected Gait in Individuals with Mild-to-Moderate Parkinson’s Disease. Appl. Sci.2024, 14, 1271.
Harro, C.; Alderink, G.; Hickox, L.; Zeitler, D.W.; Avery, M.; Daman, C.; Laker, D. Dynamic Measures of Balance during Obstacle-Crossing in Self-Selected Gait in Individuals with Mild-to-Moderate Parkinson’s Disease. Appl. Sci. 2024, 14, 1271.
Abstract
Individuals with Parkinson’s Disease (PD) are at an increased risk of falls due to associated motor symptoms and impaired postural control. Gait dysfunction, observed soon after diagnosis, leads to disability with disease progression. The purpose of this study was to determine if there were differences in dynamic postural control during self-paced walking and obstacle-crossing between persons with mild to moderate PD and healthy controls. Participants included nine individuals with mild to moderate PD (PD cohort) and nine age- and gender-matched controls (CON cohort). Anatomical marker trajectories and ground reaction forces were collected as participants walked along the pathway. Three successful representative right and left gait cycles were analyzed using Visual3D biomechanical software. Analyses, involving a mixed model ANOVA using R Statistical Software, examined spatiotemporal (ST) gait parameters for strides involving the leading and trailing limbs and dynamic balance variables, including COM - COP inclination angle, and the COP - COM M/L, COP - XCOM M/L, UMAX - XCOM M/L distances, at distinct points from the stance limb related to the leading and trailing legs. There were no differences between CON and PD for all ST gait parameters during obstacle crossing, except for a significantly reduced step length (p = 0.00489) for the PD group related to the trailing limb. However, there were significant main effects of Step and Condition interacting with Step for swing time, stance time, and step length. For both CON and PD groups the COP - COM , COP - XCOM , UMAX - XCOM metrics demonstrated that the COM was medial to the BOS from first double support, generally moving more medially through second double support for the stance limb during motion of the leading and trailing limbs. Event and Event interacting with Condition were significant for the COP - COM and COP - XCOM variables, while UMAX – XCOM was significant only for Event (p < 0.001). The PD group demonstrated significantly larger mean values for COP – COM M/L at first double support (p = 0.00435) and COP - XCOM M/L at second double support (p = 0.0158) for the second step. Our results suggest that the margin of stability may be useful in discerning dynamic postural control adaptations during walking and obstacle negotiation in persons with mild PD.
Keywords
spatiotemporal gait parameters; center of pressure; center of mass; extrapolated center of mass; margin of stability
Subject
Biology and Life Sciences, Neuroscience and Neurology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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