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Control of dynamic stability during gait termination on a slippery surface in Parkinson's disease

Authors

  • Alison R. Oates PhD,

    Corresponding author
    1. Gait and Posture Laboratory, Kinesiology Department, University of Waterloo, Waterloo, Ontario, Canada
    2. School of Occupational and Physical Therapy, University of McGill, Montreal, Quebec, Canada
    • CRIR Research Centre, Jewish Rehabilitation Hospital, 3205 Place Alton Goldbloom, Laval, Quebec, Canada
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  • Jim S. Frank PhD,

    1. Gait and Posture Laboratory, Kinesiology Department, University of Waterloo, Waterloo, Ontario, Canada
    2. Department of Graduate Studies, University of Windsor, Windsor, Ontario, Canada
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  • Aftab E. Patla PhD,

    1. Gait and Posture Laboratory, Kinesiology Department, University of Waterloo, Waterloo, Ontario, Canada
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  • Karen VanOoteghem BSc,

    1. Gait and Posture Laboratory, Kinesiology Department, University of Waterloo, Waterloo, Ontario, Canada
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  • Fay B. Horak PT, PhD

    1. Balance Disorders Laboratory, Neurological Sciences Institute, Oregon Health and Science University, Beaverton, Oregon
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Abstract

This study investigated how Parkinson's disease (PD) affects the ability to switch from locomotion to gait termination (GT) during planned and cued GT and examined the effect of PD on the integration of a reactive, balance maintenance strategy into voluntary GT. After a series of stops on a stable surface, eight participants with and 10 without PD stopped on a surface, which slid quickly and unexpectedly forward mimicking a slippery surface. PD caused instability during the completely voluntary nonslippery stops (P = 0.012) but not during the slippery stops, which required a reactive movement. The PD group walked slower [0.9–1.0 m/s vs. 1.3 m/s, respectively (P < 0.001)] with shorter steps during the first step of nonslippery GT (P = 0.016) and with wider steps during all steps of nonslippery GT (P ≤ 0.05). Similar to controls, the PD group increased lateral stability during planned GT compared to cued GT (P = 0.007). The timing of gait termination was similar between groups in all conditions. During the unexpected perturbation, both groups used a generalized slip response to regain balance after the perturbation. PD did not affect the ability to stop walking or to integrate a balance-correcting response into GT but did affect movement speed, size, and stability of the voluntary movement. © 2008 Movement Disorder Society

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