Dopamine replacement therapy normalizes reactive step length to postural perturbations in Parkinson's disease.
Balance
Levodopa
Parkinson’s disease
Postural Instability
Step Length
Journal
Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
received:
08
11
2022
revised:
26
01
2023
accepted:
29
01
2023
pmc-release:
01
03
2024
pubmed:
12
2
2023
medline:
21
3
2023
entrez:
11
2
2023
Statut:
ppublish
Résumé
Postural instability is one of the most disabling motor symptoms of Parkinson's disease (PD) given its association with falls and loss of independence. Previous studies have assessed biomechanical measures of reactive stepping in response to perturbations, showing that individuals with PD exhibit inadequate postural responses to regain balance. Does dopamine replacement therapy normalize step length in response to balance perturbations? In this study, we estimated reactive step length, to a postural perturbation, retrospectively from a dataset of frontal plane video using 2D motion tracking and direct linear transform methods. We compared two perturbation methods: support surface translation and shoulder pull (the clinical standard) in 14 individuals with PD and 13 without PD (on and off medication), with and without partial body weight support (BWS). The primary outcome was the length of the first step taken to regain balance after the perturbation analyzed with mixed effects ANOVA, with post hoc analysis of anteroposterior (AP) and mediolateral (ML) components. PD OFF medication exhibited shorter reactive step length compared to PD ON and compared to control groups for the surface translation perturbations, but no significant difference was observed for the shoulder pull perturbations. Dopamine replacement therapy affects step length in response to perturbation more robustly for surface translations than for a pull by the shoulders.
Sections du résumé
BACKGROUND
Postural instability is one of the most disabling motor symptoms of Parkinson's disease (PD) given its association with falls and loss of independence. Previous studies have assessed biomechanical measures of reactive stepping in response to perturbations, showing that individuals with PD exhibit inadequate postural responses to regain balance.
RESEARCH QUESTION
Does dopamine replacement therapy normalize step length in response to balance perturbations?
METHODS
In this study, we estimated reactive step length, to a postural perturbation, retrospectively from a dataset of frontal plane video using 2D motion tracking and direct linear transform methods. We compared two perturbation methods: support surface translation and shoulder pull (the clinical standard) in 14 individuals with PD and 13 without PD (on and off medication), with and without partial body weight support (BWS). The primary outcome was the length of the first step taken to regain balance after the perturbation analyzed with mixed effects ANOVA, with post hoc analysis of anteroposterior (AP) and mediolateral (ML) components.
RESULTS
PD OFF medication exhibited shorter reactive step length compared to PD ON and compared to control groups for the surface translation perturbations, but no significant difference was observed for the shoulder pull perturbations.
SIGNIFICANCE
Dopamine replacement therapy affects step length in response to perturbation more robustly for surface translations than for a pull by the shoulders.
Identifiants
pubmed: 36773480
pii: S0966-6362(23)00032-2
doi: 10.1016/j.gaitpost.2023.01.022
pmc: PMC10023411
mid: NIHMS1875758
pii:
doi:
Substances chimiques
Dopamine
VTD58H1Z2X
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
95-100Subventions
Organisme : NINDS NIH HHS
ID : P50 NS098573
Pays : United States
Organisme : NINDS NIH HHS
ID : P50 NS123109
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS124814
Pays : United States
Informations de copyright
Copyright © 2023 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Interest There are no conflicts of interest.
Références
J Neurophysiol. 2016 Aug 1;116(2):493-502
pubmed: 27098030
Mov Disord. 2015 Sep;30(10):1361-70
pubmed: 26095928
Mov Disord. 2008 Jul 30;23(10):1453-7
pubmed: 18512752
J Parkinsons Dis. 2015;5(1):43-7
pubmed: 25613349
J Biomech. 2020 Nov 9;112:110017
pubmed: 32927127
Gait Posture. 2021 Feb;84:205-208
pubmed: 33360643
Parkinsons Dis. 2019 Oct 24;2019:6304842
pubmed: 31772733
Mov Disord. 2008 Nov 15;23(15):2129-70
pubmed: 19025984
Nat Neurosci. 2018 Sep;21(9):1281-1289
pubmed: 30127430
J Neurol. 2005 Nov;252(11):1310-5
pubmed: 15895303
J Neurol. 2014 Dec;261(12):2330-7
pubmed: 25228002
J Neurol. 2023 Jan;270(1):386-393
pubmed: 36100730
PLoS One. 2021 May 27;16(5):e0252119
pubmed: 34043678
P T. 2015 Aug;40(8):504-32
pubmed: 26236139
J Neurophysiol. 2009 Nov;102(5):2910-20
pubmed: 19741108
CNS Drugs. 2013 Feb;27(2):97-112
pubmed: 23076544
Neurophysiol Clin. 2015 Nov;45(4-5):371-88
pubmed: 26319759
Brain Sci. 2019 Sep 18;9(9):
pubmed: 31540441
Neurology. 2004 Jan 13;62(1):125-7
pubmed: 14718714
J Neurol. 2006 Nov;253(11):1404-13
pubmed: 16788773
Arch Phys Med Rehabil. 2008 Mar;89(3):492-9
pubmed: 18295628