Sit-to-walk performance in Parkinson's disease: A comparison between faller and non-faller patients. (March 2019)

• Record Type: Journal Article
• Authors: Palmisano, Chiara; Brandt, Gregor; Pozzi, Nicoló Gabriele; Leporini, Alice; Maltese, Virginia; Canessa, Andrea; Volkmann, Jens; Pezzoli, Gianni; Frigo, Carlo Albino; Isaias, Ioannis Ugo
• Is Part Of: Clinical biomechanics. Volume 63(2019)
• Page Start: 140
• Page End: 146
• Publication Date: 2019-03
• Subjects: AP anterior-posterior -- CoM centre of mass -- CoP centre of pressure -- Et execution time -- F force -- GRF ground reaction force -- HC healthy controls -- JAP− negative anterior-posterior impulse -- JAP+ positive anterior-posterior impulse -- JAPtot total anterior-posterior impulse -- PD Parkinson's disease -- PDF Parkinson's disease fallers -- PDN Parkinson's disease non-fallers -- STW sit-to-walk -- TUG timed up and go -- UPDRS Unified Parkinson's Disease Rating Scale -- V velocity -- VER vertical; Falls -- Parkinson's disease -- Sit-to-walk -- Trunk movement -- Timed up and go; Biomechanics -- Periodicals; Osteopathic medicine -- Periodicals; Biomechanics -- Periodicals; Osteopathic Medicine -- Periodicals; 612.76
• DOI: 10.1016/j.clinbiomech.2019.03.002
• Languages: English
• ISSNs: 0268-0033

Abstract

Abstract: Background: Falls are one of the main concerns in people with Parkinson's disease, leading to poor quality of life and increased mortality. The sit-to-walk movement is the most frequent postural transition task during daily life and is highly demanding in terms of balance maintenance and muscular strength. Methods: With the aim of identifying biomechanical variables of high risk of falling, we investigated the sit-to-walk task performed by 9 Parkinson's disease patients with at least one fall episode in the six months preceding this study, 15 Parkinson's disease patients without previous falls, and 20 healthy controls. Motor performance was evaluated with an optoelectronic system and two dynamometric force plates after overnight suspension of all dopaminergic drugs and one hour after consumption of a standard dose of levodopa/benserazide. Findings: Poor trunk movements critically influenced the execution of the sit-to-walk movement in patients with a history of falling. The peak velocity of the trunk in the anterior-posterior direction discriminated faller from non-faller patients, with high specificity and sensitivity in both the medication-off and -on state. Interpretation: Our results confirm the difficulties in merging consecutive motor tasks in patients with Parkinson's disease. Trunk movements during the sit-to-walk can provide valuable measurements to monitor and possibly predict the risk of falling. Highlights: Poor trunk mobility contributes to the risk of falling in Parkinson's disease Trunk velocity in Sit-to-Walk can identify faller parkinsonian patients Levodopa does not influence trunk mobility in Sit-to-Walk execution