E8 Trunk sway relates to gait and mobility measures and provides insight into increased fall risk in younger individuals with huntington's disease. (13th September 2016)

• Record Type: Journal Article
• Authors: Kegelmeyer, Deb; Kloos, Anne; Fritz, Nora; Chaudhari, Ajit; Kostyk, Sandra
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 87(2016)Supplement 1
• Page Start: A48
• Page End: A48
• Publication Date: 2016-09-13
• Subjects: trunk control -- trunk sway -- mobility -- balance -- falls; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2016-314597.134
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: Individuals with HD develop postural instability and gait deviations with concurrent loss of function. While trunk sway is a prominent symptom of HD, little is known about its impact on functional task performance. Aims: We explored the relationship among trunk sway during static and dynamic tasks and measures of gait, mobility, and falls. Methods: Forty individuals with HD (mean age = 52.05 ± 10.09, Total Functional Capacity score = 7.32 ± 3.48) participated. Trunk (thoracic and pelvic) angular excursions in sitting, standing and walking (measured with smartphone application), gait (GAITRite), mobility (Tinetti mobility test (TMT)) and falls in past week were assessed. Results: Multiple stepwise linear regression analysis showed that total pelvic anterior-posterior (AP) excursion in sitting explained 41.5% of the variance of UHDRS motor scores (p < 0.0001). Greater than 48% (R2 = 0.484) of the variance in TMT was explained by total pelvic AP excursion in walking (p < 0.0001) and total thoracic medial-lateral (ML) excursion in standing (p < 0.0001), while greater than 26% (R2 = 0.262) of the variance in velocity was explained by peak thoracic excursion in the anterior direction in walking (p = 0.015) and total pelvic AP excursion in standing (p = 0.009). Thirty-one percent (R2 = 0.310) of the variance in double support percent, the portion of the gait cycle related to balance, was explained by total pelvic excursion ML in standing (p = 0.009) and peak thoracic excursion in the posterior direction in walking (p = 0.006). Interestingly, age was negatively correlated with reported falls, with falls being associated with younger age (r = −0.44, p = 0.004) and increased posterior pelvic tilt in standing (r = 0.54, p = 0.033). Conclusions: Trunk sway measures help explain impairments in gait, mobility and falls in individuals with HD, and may represent a novel rehabilitation intervention in HD.