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P1.109 Walking along straight and curved trajectories in Parkinson's disease patients
Basic research
S37
P1.107 Contribution of proprioceptive information (Ia) in the control of postural adjustments associated to a step
P1.109 Walking along straight and curved trajectories in Parkinson’s disease patients
1 Marseille,
H. Ruget1° , T. Coyle1 , J. Blouin1 , N. Teasdale2 , L. Mouchnino1 France; 2 Laval, QC, Canada
1 Pavia, 2 Veruno,
Step over an obstacle is preceded by a characteristic Center of Pressure (CoP) shift, used to unload the leg to be moved, and termed Anticipatory Postural Adjustments (APAs). The aim was to know how the central nervous system modulated the APAs when a modification of proprioceptive information (Ia) occured during the initiation of a voluntary movement. We used the vibration of the ankle muscles acting in the lateral direction to induce modification of the afferent inflow. To test if proprioceptive inputs (Ia) were sufficient to code the movement direction we used microgravity environment to attenuate the contribution of other sensory information. Subjects were asked to cross over an obstacle eyes closed. The vibration evoked-movement was in the same direction as the unloading toward the supporting side. Three conditions were tested: No vibration, Vibration 400 ms before APAs onset and Vibration during the APAs. In microgravity we tested two conditions: Vibration and No Vibration. The results showed no vibration effect on the different phases of the APAs. Only the final “adjustments” of the CoP on one-foot support were modulated according to the biased proprioceptive information. In microgravity, a similar modification was observed for the final postural adjustments. The proprioceptive information induced by vibration and all the afferent inflow related to the body movement exaggerated sense of movement. This could lead to the decrease of the amplitude of the final adjustments. In microgravity a modification of the postural adjustments still existed and could be primarily due to the proprioceptive (Ia) input.
When walking along curved trajectories, balance control is challenged more than during walking along straight trajectories: the stride length is shorter for the inner than outer leg, the centre of mass toward the supporting leg is shifted inwards to create centripetal force, the muscle activities are slightly but significantly modified. We hypothesised that gait capacities would be more stressed in PD patients in the case of walking along curved than straight trajectories, owing to the necessary complex adaptations of the walking command. PD patients and normal subjects walked eyes-open along linear and curved trajectories (radius 1.5 m) for 1 min at self-paced cadence and velocity. The lower limbs were video-recorded with a digital camera after subjects’ and patients’ signed consent. The movies of video-recorded lower limbs were downloaded and step frequency and length along straight and curved trajectories computed. Step frequency was not affected by trajectory in either PD patients or normal subjects. Distances run by the patients were smaller than normal under both conditions, but more so during curved walking. No correlation was found between the above variables and severity and duration of the disease, or the frequency of falls of patients.
S. Guglielmetti2 , A. Nardone2 , M. Schieppati1° Italy
P1.108 Dual task interference during gait in patients with ataxia F. Ozcan, M. Demirkiran, Y. Sarica° Adana, Turkey Objective: This study is planned to investigate the effects of dual task interference during gait in patients with spinocerebellar ataxia (SCA). Method: Thirty patients with SCA and 30 age- and sex-matched healthy controls were enrolled in the study. Neurologic examination, mini mental state examination, Tinetti balance scale, international cooperative ataxia rating scale were performed in all subjects. Gait tests for dual task interference were carried out under four different conditions: (1) at a baseline speed, (2) buttonning, (3) verbal fluency, (4) during simultaneous buttonning and verbal fluency. Duration and number of steps within the middle 6 meters of a 10-meter walkway were recorded. Gait speed and cadence were calculated; the differences in gait varibles between the two groups were analysed. The effects of clinical variables on gait, such as height, weight, age, duration of disease, and degree of disability, were investigated. Results: Patients with SCA walked slower than control group during baseline, motor and cognitive tasks (P < 0.001). However, cognitive task affected gait speed more than motor task. Simultaneous tasks of motor and cognitive performance affected gait speed more than a single task. For the control group similar results were obtained, however, single motor task did not have much effect on gait speed. Conclusion: To our knowledge, this is the first study showing dual task interference during gait in patients with SCA. Their gait speed slowed depending on both the type and the number of task. Similar studies may help to determine the range of problems during multiple tasks in SCA.
Walking along curved trajectories highlights impaired balance control in PD patients. This suggests routinely evaluating and training their gait capacities along both straight and curved trajectories.
P1.110 Validation of the Falls efficacy Scale (FES) and the Falls efficacy Scale International (FES-I) in patients with/without cognitive impairment M. Schwenk1° , K. Hauer1 , L. Yardley2 , N. Beyer3 , R. Kempen4 , M. Campbell5 , C. Becker6 , C. Todd7 1 Heidelberg, Germany; 2 Southampton, UK; 3 Copenhagen, Denmark; 4 Maastricht, The Netherlands; 5 Stuttgart, Germany; 6 Manchester, UK Background and Aim: So far no questionnaires which document fallrelated self efficacy/fear of falling have been validated for frail older persons with cognitive impairment nor for different administration methods such as self report or interview. The aim of the study was to validate the self-report and interview version of the Falls efficacy Scale (FES) and Falls efficacy Scale-International (FES-I) in frail geriatric patients with and without cognitive impairment. Methods: 156 geriatric patients of geriatric rehabilitations wards with (n = 75) and without cognitive impairment (n = 81) were included in this study. Reports of fall related self efficacy were based on self-reported and interview based questionnaires. Descriptive statistics, reliability estimates
S37
P1.107 Contribution of proprioceptive information (Ia) in the control of postural adjustments associated to a step
P1.109 Walking along straight and curved trajectories in Parkinson’s disease patients
1 Marseille,
H. Ruget1° , T. Coyle1 , J. Blouin1 , N. Teasdale2 , L. Mouchnino1 France; 2 Laval, QC, Canada
1 Pavia, 2 Veruno,
Step over an obstacle is preceded by a characteristic Center of Pressure (CoP) shift, used to unload the leg to be moved, and termed Anticipatory Postural Adjustments (APAs). The aim was to know how the central nervous system modulated the APAs when a modification of proprioceptive information (Ia) occured during the initiation of a voluntary movement. We used the vibration of the ankle muscles acting in the lateral direction to induce modification of the afferent inflow. To test if proprioceptive inputs (Ia) were sufficient to code the movement direction we used microgravity environment to attenuate the contribution of other sensory information. Subjects were asked to cross over an obstacle eyes closed. The vibration evoked-movement was in the same direction as the unloading toward the supporting side. Three conditions were tested: No vibration, Vibration 400 ms before APAs onset and Vibration during the APAs. In microgravity we tested two conditions: Vibration and No Vibration. The results showed no vibration effect on the different phases of the APAs. Only the final “adjustments” of the CoP on one-foot support were modulated according to the biased proprioceptive information. In microgravity, a similar modification was observed for the final postural adjustments. The proprioceptive information induced by vibration and all the afferent inflow related to the body movement exaggerated sense of movement. This could lead to the decrease of the amplitude of the final adjustments. In microgravity a modification of the postural adjustments still existed and could be primarily due to the proprioceptive (Ia) input.
When walking along curved trajectories, balance control is challenged more than during walking along straight trajectories: the stride length is shorter for the inner than outer leg, the centre of mass toward the supporting leg is shifted inwards to create centripetal force, the muscle activities are slightly but significantly modified. We hypothesised that gait capacities would be more stressed in PD patients in the case of walking along curved than straight trajectories, owing to the necessary complex adaptations of the walking command. PD patients and normal subjects walked eyes-open along linear and curved trajectories (radius 1.5 m) for 1 min at self-paced cadence and velocity. The lower limbs were video-recorded with a digital camera after subjects’ and patients’ signed consent. The movies of video-recorded lower limbs were downloaded and step frequency and length along straight and curved trajectories computed. Step frequency was not affected by trajectory in either PD patients or normal subjects. Distances run by the patients were smaller than normal under both conditions, but more so during curved walking. No correlation was found between the above variables and severity and duration of the disease, or the frequency of falls of patients.
S. Guglielmetti2 , A. Nardone2 , M. Schieppati1° Italy
P1.108 Dual task interference during gait in patients with ataxia F. Ozcan, M. Demirkiran, Y. Sarica° Adana, Turkey Objective: This study is planned to investigate the effects of dual task interference during gait in patients with spinocerebellar ataxia (SCA). Method: Thirty patients with SCA and 30 age- and sex-matched healthy controls were enrolled in the study. Neurologic examination, mini mental state examination, Tinetti balance scale, international cooperative ataxia rating scale were performed in all subjects. Gait tests for dual task interference were carried out under four different conditions: (1) at a baseline speed, (2) buttonning, (3) verbal fluency, (4) during simultaneous buttonning and verbal fluency. Duration and number of steps within the middle 6 meters of a 10-meter walkway were recorded. Gait speed and cadence were calculated; the differences in gait varibles between the two groups were analysed. The effects of clinical variables on gait, such as height, weight, age, duration of disease, and degree of disability, were investigated. Results: Patients with SCA walked slower than control group during baseline, motor and cognitive tasks (P < 0.001). However, cognitive task affected gait speed more than motor task. Simultaneous tasks of motor and cognitive performance affected gait speed more than a single task. For the control group similar results were obtained, however, single motor task did not have much effect on gait speed. Conclusion: To our knowledge, this is the first study showing dual task interference during gait in patients with SCA. Their gait speed slowed depending on both the type and the number of task. Similar studies may help to determine the range of problems during multiple tasks in SCA.
Walking along curved trajectories highlights impaired balance control in PD patients. This suggests routinely evaluating and training their gait capacities along both straight and curved trajectories.
P1.110 Validation of the Falls efficacy Scale (FES) and the Falls efficacy Scale International (FES-I) in patients with/without cognitive impairment M. Schwenk1° , K. Hauer1 , L. Yardley2 , N. Beyer3 , R. Kempen4 , M. Campbell5 , C. Becker6 , C. Todd7 1 Heidelberg, Germany; 2 Southampton, UK; 3 Copenhagen, Denmark; 4 Maastricht, The Netherlands; 5 Stuttgart, Germany; 6 Manchester, UK Background and Aim: So far no questionnaires which document fallrelated self efficacy/fear of falling have been validated for frail older persons with cognitive impairment nor for different administration methods such as self report or interview. The aim of the study was to validate the self-report and interview version of the Falls efficacy Scale (FES) and Falls efficacy Scale-International (FES-I) in frail geriatric patients with and without cognitive impairment. Methods: 156 geriatric patients of geriatric rehabilitations wards with (n = 75) and without cognitive impairment (n = 81) were included in this study. Reports of fall related self efficacy were based on self-reported and interview based questionnaires. Descriptive statistics, reliability estimates