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Falls in Parkinson's disease : kinematic evidence for impaired head and trunk control

Cole, Michael H., Silburn, Peter A., Wood, Joanne M., Worringham, Charles J., & Kerr, Graham K. (2010) Falls in Parkinson's disease : kinematic evidence for impaired head and trunk control. Movement Disorders, 25(14), pp. 2369-2378.

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Abstract

Changes in stride characteristics and gait rhythmicity characterize gait in Parkinson's disease and are widely believed to contribute to falls in this population. However, few studies have examined gait in PD patients who fall. This study reports on the complexities of walking in PD patients who reported falling during a 12-month follow-up. Forty-nine patients clinically diagnosed with idiopathic PD and 34 controls had their gait assessed using three-dimensional motion analysis. Of the PD patients, 32 (65%) reported at least one fall during the follow-up compared with 17 (50%) controls. The results showed that PD patients had increased stride timing variability, reduced arm swing and walked with a more stooped posture than controls. Additionally, PD fallers took shorter strides, walked slower, spent more time in double-support, had poorer gait stability ratios and did not project their center of mass as far forward of their base of support when compared with controls. These stride changes were accompanied by a reduced range of angular motion for the hip and knee joints. Relative to walking velocity, PD fallers had increased mediolateral head motion compared with PD nonfallers and controls. Therefore, head motion could exceed “normal” limits, if patients increased their walking speed to match healthy individuals. This could be a limiting factor for improving gait in PD and emphasizes the importance of clinically assessing gait to facilitate the early identification of PD patients with a higher risk of falling.

Impact and interest:

16 citations in Scopus
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15 citations in Web of Science®

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225 since deposited on 20 Dec 2010
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ID Code: 39270
Item Type: Journal Article
Additional URLs:
Keywords: Falls, Motion Analysis, Kinematics, Gait, Postural Control
DOI: 10.1002/mds.23292
ISSN: 0885-3185
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > HUMAN MOVEMENT AND SPORTS SCIENCE (110600) > Biomechanics (110601)
Australian and New Zealand Standard Research Classification > PSYCHOLOGY AND COGNITIVE SCIENCES (170000) > COGNITIVE SCIENCE (170200)
Divisions: Current > Research Centres > Centre for Health Research
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Exercise & Nutrition Sciences
Current > Schools > School of Optometry & Vision Science
Copyright Owner: Copyright 2010 Movement Disorder Society
Deposited On: 20 Dec 2010 14:50
Last Modified: 01 Mar 2012 00:24

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