Gait Initiation and Dynamic Balance Control in Parkinson’s Disease

• Published in: Archives of physical medicine and rehabilitation Vol. 86; no. 11; pp. 2172 - 2176
• Main Authors: Hass, Chris J., Waddell, Dwight E., Fleming, Richard P., Juncos, Jorge L., Gregor, Robert J.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2005; Elsevier
• Subjects: Aged; Balance; Biological and medical sciences; Biomechanical Phenomena; Biomechanics. Biorheology; Cross-Sectional Studies; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Disability Evaluation; Diseases of the osteoarticular system; Fundamental and applied biological sciences. Psychology; Gait; Gait - physiology; Humans; Medical sciences; Middle Aged; Neurology; Parkinson disease; Parkinson Disease - complications; Parkinson Disease - physiopathology; Postural Balance - physiology; Reaction Time - physiology; Rehabilitation; Sensitivity and Specificity; Severity of Illness Index; Tissues, organs and organisms biophysics; Parkinson disease; Rehabilitation; Gait; Balance; Prognosis; Reaction force; Disability; Regulation(control); Reeducation; Center of mass; Degenerative disease; Peak; Whole body; Trajectory; Initiation; Age; Quantitative analysis; Human; Nervous system diseases; Indicator; Cerebral disorder; Biomechanics; Walking; Orthopedics; Central nervous system disease; Extrapyramidal syndrome
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2005.05.013

Hass CJ, Waddell DE, Fleming RP, Juncos JL, Gregor RJ. Gait initiation and dynamic balance control in Parkinson’s disease. To determine whether the magnitude of the separation between the center of pressure (COP) and the whole-body center of mass (COM) during gait initiation can differentiate patients with varying severity of Parkinson’s disease (PD) disability. Cross-sectional, intact groups research design. Biomechanics research laboratory. Forty-three patients were stratified into 2 groups based on the Hoehn and Yahr (H&Y) disability score, which heavily favors balance in determining disability. The 2 groups were: H&Y score of 2.0 or less (n=23; age, 61±10y) or H&Y score of 2.5 or higher (n=20; age, 70±9y). Not applicable. The peak COP-COM distance represents the maximum separation between the location of the whole-body COM and the ground reaction force’s COP, and thus is an indicator of dynamic balance control. The peak COP-COM was evaluated during 3 phases of the COP trajectory during a gait initiation task. The peak magnitude of the COP-COM distance was significantly greater during the end of the single-support phase in the less disabled patients (H&Y score ≤2.0) than in more balance disabled patients (H&Y score ≥2.5) ( P=.004). The differences in COP-COM distances between these H&Y groups suggest that patients with PD who have impaired postural control produce shorter COM-COP distances than do persons without clinically detectable balance impairment. This method of evaluation could prove a useful quantitative index to examine the impact of interventions designed to improve ambulation and balance in PD.