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Parkinson's Disease and Segmental Coordination during Turning: I. Standing Turns

Published online by Cambridge University Press:  23 September 2014

Sakineh Akram ,
James S. Frank  and
Mandar Jog
Sakineh Akram*
Affiliation:
Department of Kinesiology, University of Waterloo
James S. Frank
Affiliation:
St. Jerome's University, Waterloo
Mandar Jog
Affiliation:
Movement Disorders Program, London Health Sciences Centre, London, Ontario, Canada
*
University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada. Email: sbakram@uwaterloo.ca
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Abstract:

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Objective:

Many of the falls among people with Parkinson's disease (PD) occur during sudden, on-the-spot turning which requires systematic reorientation of axial segments towards the new direction. We examined whether a disturbance in the coordination of segmental reorientation is an important cause of turning difficulty in individuals with PD and is altered by dopaminergic medication.

Methods:

The sequence and timing of segmental reorientation during 45° and 90° on-the-spot turns was examined in fourteen individuals with PD while “off” and “on” medication and nineteen healthy controls (HC).

Results:

Regardless of the magnitude of the turn, HC reoriented their head, shoulder, and pelvis simultaneously followed by mediolateral foot displacement. PD patients displayed temporal coordination patterns similar to the HC. PD however, reduced the velocity and early magnitude of reorientation of each body segment which were both slightly improved by dopaminergic medication.

Conclusion:

Our finding that the HC and PD patients turn en bloc when the turn is predictable and there are no time constraints shows that the strategy of en bloc turning is not wrong if the movement parameters are unconstrained. However, in real life situations, which usually require quick and unpredictable turns, the en bloc strategy may be unsafe and more likely to result in falls. While in such situations HC are able to change the strategy from en bloc to sequential segmental turning, PD patients may not be able to do so and continue to turn en bloc.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 40 , Issue 4 , July 2013 , pp. 512 - 519
Copyright
Copyright © The Canadian Journal of Neurological 2013

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