000K  utf8
1100  $c2018
1500  eng
2050  urn:nbn:de:gbv:8-publ-24316
2051  10.3389/fnagi.2018.00036
3000  Schlenstedt, Christian
3010  Deuschl, Günther
3010  Hiller, Amie P.
3010  Horak, Fay
3010  Mancini, Martina
3010  Mätzler, Walter
3010  Nutt, Jay
4000  Are Hypometric Anticipatory Postural Adjustments Contributing to Freezing of Gait in Parkinson’s Disease?  [Schlenstedt, Christian]
4209  Introduction: This study aims at investigating whether impaired anticipatory postural adjustments (APA) during gait initiation contribute to the occurrence of freezing of gait (FOG) or whether altered APAs compensate for FOG in Parkinson's disease (PD).Methods:Gait initiation after 30 s quiet stance was analyzed without and with a cognitive dual task (DT) in 33 PD subjects with FOG (PD+FOG), 30 PD subjects without FOG (PD-FOG), and 32 healthy controls (HC). APAs were characterized with inertial sensors and muscle activity of the tensor fasciae latae (TFL), gastrocnemius, and tibialis anterior was captured with electromyography recordings. Nine trials (of 190) were associated with start hesitation/FOG and analyzed separately.Results:PD+FOG and PD-FOG did not differ in disease duration, disease severity, age, or gender. PD+FOG had significantly smaller medio-lateral (ML) and anterio-posterior APAs compared to PD-FOG (DT,p<0.05). PD+FOG had more co-contraction of left and right TFL during APAs compared to PD-FOG (p<0.01). Within the PD+FOG, the ML size of APA (DT) was positively correlated with the severity of FOG history (NFOG-Q), with larger APAs associated with worse FOG (rho = 0.477,p= 0.025). ML APAs were larger during trials with observed FOG compared to trials of PD+FOG without FOG.Conclusions:People with PD who have a history of FOG have smaller ML APAs (weight shifting) during gait initiation compared to PD-FOG and HC. However, start hesitation (FOG) isnotcaused by an inability to sufficiently displace the center of mass toward the stance leg because APAs were larger during trials with observed FOG. We speculate that reducing the acceleration of the body center of mass with hip abductor co-contraction for APAs might be a compensatory strategy in PD+FOG, to address postural control deficits and enable step initiation.
4950  https://doi.org/10.3389/fnagi.2018.00036$xR$3Volltext$534
4950  https://nbn-resolving.org/urn:nbn:de:gbv:8-publ-24316$xR$3Volltext$534
4961  https://macau.uni-kiel.de/receive/publ_mods_00002431
5051  610
5550  anticipatory postural adjustment
5550  electromyography
5550  freezing of gait
5550  Parkinson's disease
5550  postural balance
5550  postural control
5550  posture