Neuromuscular impairments are associated with impaired head and trunk stability during gait in Parkinson fallers
Cole, Michael H., Naughton, Geraldine A. and Silburn, Peter A.. (2017). Neuromuscular impairments are associated with impaired head and trunk stability during gait in Parkinson fallers. Neurorehabilitation and Neural Repair. 31(1), pp. 34-47. https://doi.org/10.1177/1545968316656057
|Authors||Cole, Michael H., Naughton, Geraldine A. and Silburn, Peter A.|
Background. The trunk plays a critical role in attenuating movement-related forces that threaten to challenge the body’s postural control system. For people with Parkinson’s disease (PD), disease progression often leads to dopamine-resistant axial symptoms, which impair trunk control and increase falls risk.
Objective. This prospective study aimed to evaluate the relationship between impaired trunk muscle function, segmental coordination, and future falls in people with PD.
Methods. Seventy-nine PD patients and 82 age-matched controls completed clinical assessments and questionnaires to establish their medical history, symptom severity, balance confidence, and falls history. Gait characteristics and trunk muscle activity were assessed using 3-dimensional motion analysis and surface electromyography. The incidence, cause, and consequence of any falls experienced over the next 12 months were recorded and indicated that 48 PD and 29 control participants fell at least once during this time.
Results. PD fallers had greater peak and baseline lumbar multifidus (LMF) and thoracic erector spinae (TES) activations than control fallers and nonfallers. Analysis of covariance indicated that the higher LMF activity was attributable to the stooped posture adopted by PD fallers, but TES activity was independent of medication use, symptom severity, and trunk orientation. Furthermore, greater LMF and TES baseline activity contributed to increasing lateral head, trunk, and pelvis movements in PD fallers but not nonfallers or controls.
Conclusions. The results provide evidence of neuromuscular deficits for PD fallers that are independent of medications, symptom severity, and posture and contribute to impaired head, trunk, and pelvis control associated with falls in this population.
|Keywords||Parkinson disease; electromyography; accidental falls; quality of life|
|Journal||Neurorehabilitation and Neural Repair|
|Journal citation||31 (1), pp. 34-47|
|Publisher||SAGE Publications Inc.|
|Digital Object Identifier (DOI)||https://doi.org/10.1177/1545968316656057|
|Open access||Published as green open access|
|Funder||National Health and Medical Research Council|
|Research Group||Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre|
|Author's accepted manuscript|
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This record includes an accepted manuscript. Cole, M.H., Naughton, G.A. and Silburn, P.A., Neuromuscular impairments are associated with impaired head and trunk stability during gait in Parkinson fallers, Neurorehabilitation and Neural Repair, 31(1), pp. 34-47. Copyright © 2017 The Author(s). Reprinted by permission of SAGE Publications. DOI: 10.1177/1545968316656057
|Place of publication||United States of America|
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