AI Article Synopsis
- The study explored how muscle synergies change in patients with Parkinson's disease (PD) before they start walking and how shifting gaze affects this process.
- It involved PD patients and control groups performing a gait initiation task, examining muscle activation strategies and stability metrics.
- Findings revealed that PD patients had lower stability indices and less effective adjustments during gait initiation compared to controls, suggesting early signs of gait issues in PD that could lead to problems like freezing of gait.
Article Abstract
Objective: We investigated changes in indices of muscle synergies prior to gait initiation and the effects of gaze shift in patients with Parkinson's disease (PD). A long-term objective of the study is to develop a method for quantitative assessment of gait-initiation problems in PD.
Methods: PD patients without clinical signs of postural instability and two control groups (age-matched and young) performed a gait initiation task in a self-paced manner, with and without a quick prior gaze shift produced by turning the head. Muscle groups with parallel scaling of activation levels (muscle modes) were identified as factors in the muscle activation space. Synergy index stabilizing center of pressure trajectory in the anterior-posterior and medio-lateral directions (indices of stability) was quantified in the muscle mode space. A drop in the synergy index in preparation to gait initiation (anticipatory synergy adjustment, ASA) was quantified.
Results: Compared to the control groups, PD patients showed significantly smaller synergy indices and ASA for both directions of the center of pressure shift. Both PD and age-matched controls, but not younger controls, showed detrimental effects of the prior gaze shift on the ASA indices.
Conclusions: PD patients without clinically significant posture or gait disorders show impaired stability of the center of pressure and its diminished adjustment during gait initiation.
Significance: The indices of stability and ASA may be useful to monitor pre-clinical gait disorders, and lower ASA may be relevant to emergence of freezing of gait in PD.
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| http://dx.doi.org/10.1016/j.clinph.2023.06.022 | DOI Listing |
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