‘Recoupling’ the attentional and motor control of preparatory postural adjustments to overcome freezing of gait in Parkinson’s
| Autor: | Anna Fielding, Meriel Norris, William R. Young, Amy Maslivec, Mark R. Wilson |
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| Rok vydání: | 2020 |
| Předmět: |
Male
030506 rehabilitation medicine.medical_specialty Neurology genetic structures Step initiation step initiation Health Informatics freezing of gait lcsh:RC321-571 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation 0903 Biomedical Engineering Start hesitation medicine Humans anticipatory postural adjustment Attention lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry Parkinson’s Gait Disorders Neurologic Aged Anticipatory postural adjustment weight-shifting festination Freezing of gait Research Festination Rehabilitation Motor control Parkinson Disease Cognition Middle Aged Weight-shifting Gait Exercise Therapy start hesitation Cueing Female 0305 other medical science Psychology 1109 Neurosciences 030217 neurology & neurosurgery cueing |
| Zdroj: | Journal of NeuroEngineering and Rehabilitation, Vol 17, Iss 1, Pp 1-13 (2020) Journal of NeuroEngineering and Rehabilitation |
| Popis: | Objectives This study examined if people with Parkinson’s and freezing of gait pathology (FoG) could be trained to increase preparatory weight-shift amplitude, and facilitate step initiation during FoG. Methods Thirty-five people with Parkinson’s and FoG attempted to initiate forward walking from a stationary position caused by a freeze (n = 17, FoG-F) or voluntarily stop (n = 18, FoG-NF) in a Baseline condition and two conditions where an increased weight-shift amplitude was trained via: (i) explicit verbal instruction, and (ii) implicit movement analogies. Results At Baseline, weight-shift amplitudes were smaller during: (i) unsuccessful, compared to successful step initiations (FoG-F group), and (ii) successful step initiations in the FoG-F group compared to FoG-NF. Both Verbal and Analogy training resulted in significant increases in weight-shift amplitude in both groups, and a corresponding pronounced reduction in unsuccessful attempts to initiate stepping (FoG-F group). Conclusions Hypometric preparatory weight-shifting is associated with failure to initiate forward stepping in people with Parkinson’s and FoG. However, impaired weight-shift characteristics are modifiable through conscious strategies. This current study provides a novel and critical evaluation of preparatory weight-shift amplitudes during FoG events. The intervention described represents an attractive ‘rescue’ strategy and should be further scrutinised regarding limitations posed by physical and cognitive deficits. |
| Databáze: | OpenAIRE |
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