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Falls in Parkinson's disease: Kinematic evidence for impaired head and trunk control
Cole, Michael H. Silburn, Peter A. Wood, Joanne M. Worringham, Charles J. Kerr, Graham K.
Cole, Michael H.
Silburn, Peter A.
Wood, Joanne M.
Worringham, Charles J.
Kerr, Graham K.
Abstract
Changes in stride characteristics and gait rhythmicity characterize gait in Parkinson's disease and are widely believed to contribute to falls in this population. However, few studies have examined gait in PD patients who fall. This study reports on the complexities of walking in PD patients who reported falling during a 12-month follow-up. Forty-nine patients clinically diagnosed with idiopathic PD and 34 controls had their gait assessed using three-dimensional motion analysis. Of the PD patients, 32 (65%) reported at least one fall during the follow-up compared with 17 (50%) controls. The results showed that PD patients had increased stride timing variability, reduced arm swing and walked with a more stooped posture than controls. Additionally, PD fallers took shorter strides, walked slower, spent more time in double-support, had poorer gait stability ratios and did not project their center of mass as far forward of their base of support when compared with controls. These stride changes were accompanied by a reduced range of angular motion for the hip and knee joints. Relative to walking velocity, PD fallers had increased mediolateral head motion compared with PD nonfallers and controls. Therefore, head motion could exceed “normal” limits, if patients increased their walking speed to match healthy individuals. This could be a limiting factor for improving gait in PD and emphasizes the importance of clinically assessing gait to facilitate the early identification of PD patients with a higher risk of falling. © 2010 Movement Disorder Society
Keywords
falls, motion analysis, kinematics, gait, postural control
Date
2010
Type
Journal article
Journal
Movement Disorders
Book
Volume
25
Issue
14
Page Range
2369-2378
Article Number
ACU Department
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as green open access
License
File Access
Open
Controlled
Controlled
Notes
Authors' accepted manuscript.
This is the peer reviewed version of the following article: Cole, M. H., Silburn, P. A., Wood, J. M., Worringham, C. J. and Kerr, G. K. (2010), Falls in Parkinson's disease: Kinematic evidence for impaired head and trunk control. Mov. Disord., 25: 2369–2378. doi:10.1002/mds.23292, which has been published in final form at https://doi.org/10.1002/mds.23292. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.