Relationships Between Falls Risk, Preferred Walking Speed, and Accelerations at the Head and Trunk in Individuals with Parkinson's Disease (PD) and Healthy Elderly
Poster #: 187
Session/Time: B
Author:
Paphawee Prupetkaew, MS
Mentor:
Daniel M. Russell, PhD
Research Type: Clinical Research
Abstract
INTRODUCTION:
Bradykinesia and rigidity, common motor-symptoms in PD, can lead to reduced head-trunk control and impaired gait performance, resulting in increased fall risks. Control of the head and trunk motion is critical for maintaining dynamic stability by integrating visual, vestibular, and somatosensory inputs to generate an effective walking pattern. Increased bradykinesia and axial rigidity in PD individuals likely contribute to declines in damping accelerations from ground impacts.
METHODS:
Twenty-five older adults with PD and 25 healthy controls walked at their preferred speed (PWS). A 20 ft protokinetics mat was used to measure spatio-temporal gait parameters, and 3-D accelerometers were placed on lower trunk and head segments to assess acceleration. Root mean square (RMS) acceleration amplitudes were calculated in three dimensions (anterior-posterior: AP, mediolateral: ML, and vertical: VT). Physiological Profile Assessment (PPA) was used to determine fall risks. The relationship between fall risks, RMS acceleration and PWS was assessed using simple linear regression for each group. Differences in PWS and acceleration magnitude between groups were assessed using independent t-tests.
RESULTS:
Fall risks were associated with PWS in PD group but not healthy elderly. Individuals with PD preferred to walk slower than healthy controls, but there were no significant group differences in trunk or head accelerations. The magnitude of accelerations for all three dimensions at the trunk and the VT dimension at the head were strongly related to the PWS for both groups, with accelerations increasing with speed. The slope of the relationship between VT accelerations at the trunk and head with PWS was smaller for the individuals with PD. In contrast, the slope of the relationship between ML acceleration and PWS was smaller at the trunk and more negative at the head for healthy elderly controls.
CONCLUSION:
Individuals with PD demonstrate altered trunk and head control compared with healthy controls. The larger increase in ML accelerations of the trunk and head with speed may be associated with reduced gait stability. Individuals with PD may prefer to walk slower as a strategy to mitigate large trunk and head accelerations and a less stable gait in order to reduce risks of fall.
Bradykinesia and rigidity, common motor-symptoms in PD, can lead to reduced head-trunk control and impaired gait performance, resulting in increased fall risks. Control of the head and trunk motion is critical for maintaining dynamic stability by integrating visual, vestibular, and somatosensory inputs to generate an effective walking pattern. Increased bradykinesia and axial rigidity in PD individuals likely contribute to declines in damping accelerations from ground impacts.
METHODS:
Twenty-five older adults with PD and 25 healthy controls walked at their preferred speed (PWS). A 20 ft protokinetics mat was used to measure spatio-temporal gait parameters, and 3-D accelerometers were placed on lower trunk and head segments to assess acceleration. Root mean square (RMS) acceleration amplitudes were calculated in three dimensions (anterior-posterior: AP, mediolateral: ML, and vertical: VT). Physiological Profile Assessment (PPA) was used to determine fall risks. The relationship between fall risks, RMS acceleration and PWS was assessed using simple linear regression for each group. Differences in PWS and acceleration magnitude between groups were assessed using independent t-tests.
RESULTS:
Fall risks were associated with PWS in PD group but not healthy elderly. Individuals with PD preferred to walk slower than healthy controls, but there were no significant group differences in trunk or head accelerations. The magnitude of accelerations for all three dimensions at the trunk and the VT dimension at the head were strongly related to the PWS for both groups, with accelerations increasing with speed. The slope of the relationship between VT accelerations at the trunk and head with PWS was smaller for the individuals with PD. In contrast, the slope of the relationship between ML acceleration and PWS was smaller at the trunk and more negative at the head for healthy elderly controls.
CONCLUSION:
Individuals with PD demonstrate altered trunk and head control compared with healthy controls. The larger increase in ML accelerations of the trunk and head with speed may be associated with reduced gait stability. Individuals with PD may prefer to walk slower as a strategy to mitigate large trunk and head accelerations and a less stable gait in order to reduce risks of fall.