TY - JOUR
T1 - Medication improves balance and complex gait performance in Parkinson disease
AU - McNeely, Marie E.
AU - Duncan, Ryan P.
AU - Earhart, Gammon M.
N1 - Funding Information:
Research support was provided by the National Institute of Health/National Institute of Neurological Disease and Stroke Award Number F31 NS071639 , the National Institute of Health/National Center for Medical Rehabilitation Research Award Number R01 HD056015 , the Parkinson's Disease Foundation , the American Parkinson Disease Association (APDA) Advanced Center for PD Research at Washington University School of Medicine , and the Greater Saint Louis Chapter of the APDA . We would like to thank Samantha Herriott and Laura Pilgrim for assisting with data processing. Conflict of interest statement
PY - 2012/5
Y1 - 2012/5
N2 - Gait and balance impairments in people with Parkinson disease (PD) may lead to falls and serious injuries. Therefore, it is critical to improve our understanding of the nature of these impairments, including how they respond to prescribed anti-Parkinson medication. This is particularly important for complex balance and gait tasks that may be associated with falls. We evaluated motor function, functional balance, and gait performance during various gait tasks in 22 people with PD OFF and ON medication (PD OFF, PD ON) and 20 healthy older adults. Although MDS-UPDRS-III score, Berg Balance Scale, Mini-Balance Evaluations Systems test, and Timed-Up-and-Go improved in PD with medication, impairments persisted in all measures on medication, compared to controls. Dual task Timed-Up-and-Go did not improve with medication, and PD ON required more time than controls. Gait velocity and stride length improved similarly with medication in PD across forward, fast, backward, dual task forward, and dual task backward gait tasks. Cadence did not change with medication, nor did it differ between PD ON and controls. Velocity and stride length were reduced in PD ON compared to controls. Velocity reductions in PD ON during fast gait were cadence-mediated, while velocity reductions in backward gait were stride length-mediated. Our results suggest functional balance improves with medication in PD and gait performance improves with medication, regardless of task complexity. Remaining impairments on medication highlight the need to examine additional therapeutic options for individuals with PD to reduce the risk of falls.
AB - Gait and balance impairments in people with Parkinson disease (PD) may lead to falls and serious injuries. Therefore, it is critical to improve our understanding of the nature of these impairments, including how they respond to prescribed anti-Parkinson medication. This is particularly important for complex balance and gait tasks that may be associated with falls. We evaluated motor function, functional balance, and gait performance during various gait tasks in 22 people with PD OFF and ON medication (PD OFF, PD ON) and 20 healthy older adults. Although MDS-UPDRS-III score, Berg Balance Scale, Mini-Balance Evaluations Systems test, and Timed-Up-and-Go improved in PD with medication, impairments persisted in all measures on medication, compared to controls. Dual task Timed-Up-and-Go did not improve with medication, and PD ON required more time than controls. Gait velocity and stride length improved similarly with medication in PD across forward, fast, backward, dual task forward, and dual task backward gait tasks. Cadence did not change with medication, nor did it differ between PD ON and controls. Velocity and stride length were reduced in PD ON compared to controls. Velocity reductions in PD ON during fast gait were cadence-mediated, while velocity reductions in backward gait were stride length-mediated. Our results suggest functional balance improves with medication in PD and gait performance improves with medication, regardless of task complexity. Remaining impairments on medication highlight the need to examine additional therapeutic options for individuals with PD to reduce the risk of falls.
KW - Balance
KW - Gait
KW - Medication
KW - Parkinson disease
UR - http://www.scopus.com/inward/record.url?scp=84861989487&partnerID=8YFLogxK
U2 - 10.1016/j.gaitpost.2012.02.009
DO - 10.1016/j.gaitpost.2012.02.009
M3 - Article
C2 - 22418585
AN - SCOPUS:84861989487
VL - 36
SP - 144
EP - 148
JO - Gait and Posture
JF - Gait and Posture
SN - 0966-6362
IS - 1
ER -