Impaired Weight-Shift Amplitude in People with Parkinson's Disease with Freezing of Gait.
J Parkinsons Dis
; 11(3): 1367-1380, 2021.
Article
in En
| MEDLINE
| ID: mdl-33749618
ABSTRACT
BACKGROUND:
People with Parkinson's disease and freezing of gait (FOG; freezers) suffer from pronounced postural instability. However, the relationship between these phenomena remains unclear and has mostly been tested in paradigms requiring step generation.OBJECTIVE:
To determine if freezing-related dynamic balance deficits are present during a task without stepping and determine the influence of dopaminergic medication on dynamic balance control.METHODS:
Twenty-two freezers, 16 non-freezers, and 20 healthy age-matched controls performed mediolateral weight-shifts at increasing frequencies when following a visual target projected on a screen (MELBA task). The amplitude and phase shift differences between center of mass and target motion were measured. Balance scores (Mini-BESTest), 360° turning speed and the freezing ratio were also measured. Subjects with Parkinson's disease were tested ON and partial OFF (overnight withdrawal) dopaminergic medication.RESULTS:
Freezers had comparable turning speed and balance scores to non-freezers and took more levodopa. Freezers produced hypokinetic weight-shift amplitudes throughout the MELBA task compared to non-freezers (pâ=â0.002), which were already present at task onset (pâ<â0.001). Freezers also displayed an earlier weight-shift breakdown than controls when OFF-medication (pâ=â0.008). Medication improved mediolateral weight-shifting in freezers and non-freezers. Freezers decreased their freezing ratio in response to medication.CONCLUSION:
Hypokinetic weight-shifting proved a marked postural control deficit in freezers, while balance scores and turning speed were similar to non-freezers. Both weight-shift amplitudes and the freezing ratio were responsive to medication in freezers, suggesting axial motor vigor is levodopa-responsive. Future work needs to test whether weight-shifting and freezing severity can be further ameliorated through training.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Parkinson Disease
/
Gait Disorders, Neurologic
Type of study:
Etiology_studies
Limits:
Humans
Language:
En
Journal:
J Parkinsons Dis
Year:
2021
Type:
Article
Affiliation country:
Belgium