Altered Dynamic Postural Control during Step Turning in Persons with Early-Stage Parkinson’s Disease

Song, Jooeun; Sigward, Susan M.; Fisher, Beth E.; Salem, George J.

doi:10.1155/2012/386962

Cited by 40 publications

(43 citation statements)

References 30 publications

(49 reference statements)

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“…Postural control was analyzed before and at the completion of the study as our previous published work demonstrated it to be a sensitive motor measure in early PD [11]. Participants walked straight and turned at a 'self-selected, comfortable pace' at the designated stanchions at a right angle toward their dominant leg and then continued walking in the new direction.…”

Section: Methodsmentioning

confidence: 99%

“…Using previously reported kinematic methods, postural control during turning was quantified as the peak distance between the center of pressure (COP) of the supporting foot and the extrapolated center of mass (eCOM) [11]. Separation of the COP and the eCOM creates the momentum necessary for successful turning.…”

Section: Methodsmentioning

confidence: 99%

“…neural drive, muscle force, and joint power) to redirect and control this momentum. Previous studies have demonstrated that persons with early PD have difficulty with turning and reduced COP and eCOM distances during a turn [11]. All tests were performed by a biomechanist blinded to the treatment groups.…”

Section: Methodsmentioning

confidence: 99%

“…The purpose of this pilot study was to translate our exercise findings in animals to examine the effects of intensive treadmill exercise on DA-D 2 R binding potential (BP) using PET imaging with [ 18 F]fallypride in individuals with early-stage and unmedicated PD. We also measured exercise-induced changes in (i) motor performance, specifically turning behavior (a sensitive measure of deficits in individuals with early-stage PD) [11] and (ii) the Unified Parkinson's Disease Rating Scale (UPDRS) scores [12].…”

Section: Introductionmentioning

confidence: 99%

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Treadmill exercise elevates striatal dopamine D2 receptor binding potential in patients with early Parkinson’s disease

Fisher

Nacca³

et al. 2013

NeuroReport

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We have previously demonstrated changes in dopaminergic neurotransmission after intensive exercise in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned mouse model of Parkinson's disease (PD), including an increase in the dopamine D2 receptor (DA-D2R), using noninvasive PET imaging with the radioligand [18F]fallypride. The purpose of this feasibility and translational study was to examine whether intensive exercise leads to similar alterations in DA-D2R expression using PET imaging with [18F]fallypride in individuals with early-stage PD. In this pilot study, four patients with early-stage PD were randomized to receive intensive exercise (treadmill training sessions three times/week for 8 weeks) or no exercise. Two healthy age-matched individuals participated in treadmill training. Alterations in the DA-D2R binding potential (BP) as a marker for receptor expression were determined using PET imaging with [18F]fallypride. Turning performance in the patients with PD as a measure of postural control and the Unified Parkinson's Disease Rating Scale scores pre-exercise and postexercise were determined. Our data showed an exercise-induced increase in [18F]fallypride BP as well as improved postural control in patients with PD who exercised. Changes in DA-D2R BP were not observed in patients with PD who did not exercise. These results suggest that exercise can lead to neuroplasticity in dopaminergic signaling and contribute to improved function that may be task specific (postural control) in early-stage PD.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Treadmill exercise elevates striatal dopamine D2 receptor binding potential in patients with early Parkinson’s disease

Fisher

Nacca³

et al. 2013

NeuroReport

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200

133

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“…Such motor deficits commonly lead to poor performance in measures of balance and functional tasks, and have been associated with generalised deficits of attention and falls [3]. Difficulties with turning around the longitudinal axis are a common and early feature of PD, and can be present while lying recumbent [4], seated [5], standing [6][7][8][9][10][11][12][13][14][15] or walking [9][10][11][12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

A narrative review of turning deficits in people with Parkinson’s disease

Hulbert

Ashburn

Robert

et al. 2014

Disability and Rehabilitation

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Specific movement deficits in turning in people with PD can be categorised into axial and perpendicular deficits. Synthesis of the literature suggests the possibility of axial deficits driving secondary responses in the perpendicular segments. This should be explored when designing rehabilitation aimed at improving turning performance, as current therapy guidelines focus on exercises emphasising perpendicular aspects. Implications for Rehabilitation Turning performance is compromised in people with PD, which can lead to significant disability, falls and loss of function. Specific movement deficits can be categorised into perpendicular deficits (taking more steps and shorter steps and an altered turn strategy) and axial deficits (segment rigidity, altered segment co-ordination and timing, reduced segment rotation and the effects of altered posture). Axial deficits may drive secondary responses in the perpendicular segments during turning in people with PD. Therefore, specific focus should be made to the rehabilitation of the axial deficits alongside those of the perpendicular body segments in the design of multi-modal treatment strategies to improve turning performance.

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External validation of a 3-step falls prediction model in mild Parkinson’s disease

et al. 2016

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The 3-step falls prediction model (3-step model) that include history of falls, history of freezing of gait and comfortable gait speed <1.1 m/s was suggested as a clinical fall prediction tool in Parkinson’s disease (PD). We aimed to externally validate this model as well as to explore the value of additional predictors in 138 individuals with relatively mild PD. We found the discriminative ability of the 3-step model in identifying fallers to be comparable to previously studies [area under curve (AUC), 0.74; 95 % CI 0.65–0.84] and to be better than that of single predictors (AUC, 0.61–0.69). Extended analyses generated a new model for prediction of falls and near falls (AUC, 0.82; 95 % CI 0.75–0.89) including history of near falls, retropulsion according to the Nutt Retropulsion test (NRT) and tandem gait (TG). This study confirms the value of the 3-step model as a clinical falls prediction tool in relatively mild PD and illustrates that it outperforms the use of single predictors. However, to improve future outcomes, further studies are needed to firmly establish a scoring system and risk categories based on this model. The influence of methodological aspects of data collection also needs to be scrutinized. A new model for prediction of falls and near falls, including history of near falls, TG and retropulsion (NRT) may be considered as an alternative to the 3-step model, but needs to be tested in additional samples before being recommended. Taken together, our observations provide important additions to the evidence base for clinical fall prediction in PD.

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Altered Dynamic Postural Control during Step Turning in Persons with Early-Stage Parkinson’s Disease

Cited by 40 publications

References 30 publications

Treadmill exercise elevates striatal dopamine D2 receptor binding potential in patients with early Parkinson’s disease

Treadmill exercise elevates striatal dopamine D2 receptor binding potential in patients with early Parkinson’s disease

A narrative review of turning deficits in people with Parkinson’s disease

External validation of a 3-step falls prediction model in mild Parkinson’s disease

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