Gait bradykinesia in Parkinson’s disease: a change in the motor program which controls the synergy of gait

Warabi, Tateo; Furuyama, Hiroyasu; Sugai, Eri; Κato, Masamichi; Yanagisawa, Nobuo

doi:10.1007/s00221-017-5106-1

Cited by 13 publications

(4 citation statements)

References 59 publications

(83 reference statements)

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“…15 Previous studies have noted that rigidity and postural instability may reduce forward propulsion and thereby negatively affect stride length and stride velocity. 23,[50][51][52][53] As such, sustained improvements to rigidity and postural instability due to sensory exercise may then translate to improvements in gait parameters. 54,55 In comparison, stride length and stride velocity did not change at washout for the boxing group.…”

Section: Discussionmentioning

confidence: 99%

Boxing vs Sensory Exercise for Parkinson’s Disease: A Double-Blinded Randomized Controlled Trial

Sangarapillai

Norman

Almeida

2021

Neurorehabil Neural Repair

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Background. Exercise is increasingly becoming recognized as an important adjunct to medications in the clinical management of Parkinson’s disease (PD). Boxing and sensory exercise have shown immediate benefits, but whether they continue beyond program completion is unknown. This study aimed to investigate the effects of boxing and sensory training on motor symptoms of PD, and whether these benefits remain upon completion of the intervention. Methods. In this 20-week double-blinded randomized controlled trial, 40 participants with idiopathic PD were randomized into 2 treatment groups, (n = 20) boxing or (n = 20) sensory exercise. Participants completed 10 weeks of intervention. Motor symptoms were assessed at (week 0, 10, and 20) using the Unified Parkinson’s Disease Rating Scale (UPDRS-III). Data were analyzed using SPSS, and repeated-measures ANOVA was conducted. Results. A significant interaction effect between groups and time were observed F(1, 39) = 4.566, P = .036, where the sensory group improved in comparison to the boxing group. Post hoc analysis revealed that in comparison to boxing, the effects of exercise did not wear off at washout (week 20) P < .006. Conclusion. Future rehabilitation research should incorporate similar measures to explore whether effects of exercise wear off post intervention.

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Section: Discussionmentioning

confidence: 99%

Boxing vs Sensory Exercise for Parkinson’s Disease: A Double-Blinded Randomized Controlled Trial

Sangarapillai

Norman

Almeida

2021

Neurorehabil Neural Repair

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“…Impairments to these structures, for instance from cell loss associated with Parkinson’s Disease, leads to reduced ability to switch between reflexive and goal-directed behavior, e.g. a reduced ability to voluntarily initiate gait from a standing posture, or the freezing of gait in some people with PD, which predominantly occurs in situations where environmental constraints require a goal-directed, planned modulation of a steady-state gait pattern, such as navigating through a doorway or over an obstacle 87 , 88 . A mechanistic understanding of how impairments in neural function lead to specific motor deficits would require a model that encompasses both volitional and habitual movements, the neural mechanisms switching between them, and the integration with the spinal reflexes, muscle physiology and biomechanics that ultimately generate the movement.…”

Section: Discussionmentioning

confidence: 99%

A neuromuscular model of human locomotion combines spinal reflex circuits with voluntary movements

Ramadan

Geyer

Jeka

et al. 2022

Sci Rep

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Existing models of human walking use low-level reflexes or neural oscillators to generate movement. While appropriate to generate the stable, rhythmic movement patterns of steady-state walking, these models lack the ability to change their movement patterns or spontaneously generate new movements in the specific, goal-directed way characteristic of voluntary movements. Here we present a neuromuscular model of human locomotion that bridges this gap and combines the ability to execute goal directed movements with the generation of stable, rhythmic movement patterns that are required for robust locomotion. The model represents goals for voluntary movements of the swing leg on the task level of swing leg joint kinematics. Smooth movements plans towards the goal configuration are generated on the task level and transformed into descending motor commands that execute the planned movements, using internal models. The movement goals and plans are updated in real time based on sensory feedback and task constraints. On the spinal level, the descending commands during the swing phase are integrated with a generic stretch reflex for each muscle. Stance leg control solely relies on dedicated spinal reflex pathways. Spinal reflexes stimulate Hill-type muscles that actuate a biomechanical model with eight internal joints and six free-body degrees of freedom. The model is able to generate voluntary, goal-directed reaching movements with the swing leg and combine multiple movements in a rhythmic sequence. During walking, the swing leg is moved in a goal-directed manner to a target that is updated in real-time based on sensory feedback to maintain upright balance, while the stance leg is stabilized by low-level reflexes and a behavioral organization switching between swing and stance control for each leg. With this combination of reflex-based stance leg and voluntary, goal-directed control of the swing leg, the model controller generates rhythmic, stable walking patterns in which the swing leg movement can be flexibly updated in real-time to step over or around obstacles.

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“…Impairments to these structures, for instance from cell loss associated with Parkinson's Disease, leads to reduced ability to switch between reflexive and goal-directed behavior, e.g. a reduced ability to voluntarily initiate gait from a standing posture, or the freezing of gait in some people with PD, which predominantly occurs in situations where environmental constraints require a goal-directed, planned modulation of a steady-state gait pattern, such as navigating through a doorway or over an obstacle (Peterson and Horak, 2016;Warabi et al, 2018). A mechanistic understanding of how impairments in neural function lead to specific motor deficits would require a model that encompasses both volitional and habitual movements, the neural mechanisms switching between them, and the integration with the spinal reflexes, muscle physiology and biomechanics that ultimately generate the movement.…”

Section: Motor Plans and Voluntary Movementsmentioning

confidence: 99%

A Neuromuscular Model of Human Locomotion Combines Spinal Reflex Circuits with Voluntary Movements

Ramadan

Geyer

Jeka

et al. 2021

Preprint

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Existing models of human walking use low-level reflexes or neural oscillators to generate movement. While appropriate to generate the stable, rhythmic movement patterns of steady-state walking, these models lack the ability to change their movement patterns or spontaneously generate new movements in the specific, goal-directed way characteristic of voluntary movements. Here we present a neuromuscular model of human locomotion that bridges this gap and combines the ability to execute goal directed movements with the generation of stable, rhythmic movement patterns that are required for robust locomotion. The model represents goals for voluntary movements of the swing leg on the task level of swing leg joint kinematics. Smooth movements plans towards the goal configuration are generated on the task level and transformed into descending motor commands that execute the planned movements, using internal models. The movement goals and plans are updated in real time based on sensory feedback and task constraints. On the spinal level, the descending commands during the swing phase are integrated with a generic stretch reflex for each muscle. Stance leg control solely relies on dedicated spinal reflex pathways. Spinal reflexes stimulate Hill-type muscles that actuate a biomechanical model with eight internal joints and six free-body degrees of freedom. The model is able to generate voluntary, goal-directed reaching movements with the swing leg and combine multiple movements in a rhythmic sequence. During walking, the swing leg is moved in a goal-directed manner to a target that is updated in real-time based on sensory feedback to maintain upright balance, while the stance leg is stabilized by low-level reflexes and a behavioral organization switching between swing and stance control for each leg. With this combination of reflexive stance leg and voluntary, goal-directed control of the swing leg, the model controller generates rhythmic, stable walking patterns in which the swing leg movement can be flexibly updated in real-time to step over or around obstacles.

show abstract

Gait bradykinesia in Parkinson’s disease: a change in the motor program which controls the synergy of gait

Cited by 13 publications

References 59 publications

Boxing vs Sensory Exercise for Parkinson’s Disease: A Double-Blinded Randomized Controlled Trial

Boxing vs Sensory Exercise for Parkinson’s Disease: A Double-Blinded Randomized Controlled Trial

A neuromuscular model of human locomotion combines spinal reflex circuits with voluntary movements

A Neuromuscular Model of Human Locomotion Combines Spinal Reflex Circuits with Voluntary Movements

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