Anticipatory Postural Adjustment During Self-Initiated, Cued, and Compensatory Stepping in Healthy Older Adults and Patients With Parkinson Disease.
Christian Schlenstedt, Martina Mancini, Fay Horak and 1 others
PMID 28254637WHAT IT FOUND
In healthy adults, cued stepping increased postural preparation before stepping, while a balance recovery step decreased it.
In mild Parkinson disease, the change across these conditions was less pronounced than in healthy adults, and levodopa did not change step preparation.
Key findings
01In healthy adults, a perceptual cue increased the side-to-side anticipatory postural adjustment compared with self-initiated stepping, while compensatory stepping decreased it.
02People with Parkinson disease Off levodopa showed a less pronounced decrease in side-to-side anticipatory postural adjustment from cued to compensatory stepping than healthy adults.
03Levodopa did not significantly change the size of the side-to-side anticipatory postural adjustment, step length, step velocity, or step duration.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The people with Parkinson disease were mildly affected, so the results may not apply to more severe disease. Participants stood with feet close together, which may have reduced differences between groups and between medication states. Healthy controls were compared only with people with Parkinson disease Off levodopa, not with the On state that may be closer to everyday function. Only the side-to-side anticipatory postural adjustment was analyzed for all conditions because platform movement affected the forward-backward signal. No falls occurred, and the perturbations may not have been severe enough to test whether people with Parkinson disease can step quickly enough to prevent a fall.
Declared interests
The article text provided does not include a conflict-of-interest or funding statement. The publication types list NIH, non-U.S. government, and U.S. government non-PHS research support.
The easy way to misread this
Do not conclude that levodopa does not improve step preparation in Parkinson disease. It did not change the laboratory measures in this mild sample, and the study did not compare healthy controls with people with Parkinson disease On medication.