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Research Reports |
M Martin, PT, MS, is Staff Physical Therapist, 64th Combat Support Hospital, US Army, Wurzburg, Germany
M Shinberg, PT, MSPT, is Physical Therapist, Shriner's Hospital for Children, Philadelphia, Pa
M Kuchibhatla, PhD, is Assistant Research Professor, Department of Biostatistics and Bioinformatics, Center for the Study of Aging and Human Development, Duke University, Durham, NC
L Ray, PT, MS, is Pediatric Physical Therapist, Duke University Health System, Durham, NC
JJ Carollo, PhD, PE, is Director, Center for Gait and Movement Analysis, The Childrens Hospital, Denver, Colo, and University of Colorado Health Sciences Center, Denver, Colo
ML Schenkman, PT, PhD, is Professor, Physical Therapy Program, University of Colorado Health Sciences Center, C-244, 4200 E Ninth Ave, Denver, CO 80262-0244 (USA) (margaret.schenkman{at}UCHSC.edu).
Address all correspondence to Dr Schenkman
Background and Purpose. Initiation of gait requires transitions from relatively stationary positions to stability with movement and from double- to single-limb stances. These are deliberately destabilizing activities that may be difficult for people with early Parkinson disease (PD), even when they have no problems with level walking. We studied differences in postural stability during gait initiation between participants with early and middle stages of PD (characterized by Hoehn and Yahr as stages 1–3) and 2 other groups of participants without PD—older and younger adults. Subjects. The mean ages of the 3 groups of participants were as follows: subjects with PD, 69.3 years (SD=5.7, range=59–78); older subjects without PD, 69.0 years (SD=3.9, range=65–79); and younger subjects without PD, 27.5 (SD=3.9, range=22–35). Methods. A 3-dimensional motion analysis system was used with 2 force platforms to obtain data for center of mass (COM) and center of pressure (COP). The distance between the vertical projections of the COM and the COP (COM–COP distance) was used to reflect postural control during 5 events in gait initiation. Results. By use of multivariate analysis of variance, differences in COM–COP distance were found among the 3 groups. An analysis of variance indicated differences for 4 of the 5 events in gait initiation. A Scheffe post hoc analysis demonstrated differences in gait initiation between the subjects with PD and both groups of subjects without PD (2 events) and between the subjects with PD and the younger subjects without PD (2 events). Discussion and Conclusion. The COM–COP distance relationship was used to measure postural control during the transition from quiet standing to steady-state gait. Differences between groups indicated that individuals with impaired postural control allow less COM–COP distance than do individuals with no known neurologic problems. The method used could prove useful in the development and assessment of interventions to improve ambulation safety and enhance the independence of people with impaired postural control.
Key Words: Gait analysis • Gait initiation • Kinesiology/biomechanics • Neuromuscular disorders • Parkinson disease
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  A. Nieuwboer, R. Dom, W. De Weerdt, K. Desloovere, L. Janssens, and V. Stijn Electromyographic profiles of gait prior to onset of freezing episodes in patients with Parkinson's disease Brain, July 1, 2004; 127(7): 1650 - 1660. [Abstract] [Full Text] [PDF]
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