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- All Subjects: Parkinson's disease
- Creators: Ingalls, Todd
Description
Parkinson's disease (PD) is a neurodegenerative disorder that produces a characteristic set of neuromotor deficits that sometimes includes reduced amplitude and velocity of movement. Several studies have shown that people with PD improved their motor performance when presented with external cues. Other work has demonstrated that high velocity and large amplitude exercises can increase the amplitude and velocity of movement in simple carryover tasks in the upper and lower extremities. Although the cause for these effects is not known, improvements due to cueing suggest that part of the neuromotor deficit in PD is in the integration of sensory feedback to produce motor commands. Previous studies have documented some somatosensory deficits, but only limited information is available regarding the nature and magnitude of sensorimotor deficits in the shoulder of people with PD. The goals of this research were to characterize the sensorimotor impairment in the shoulder joint of people with PD and to investigate the use of visual feedback and large amplitude/high velocity exercises to target PD-related motor deficits. Two systems were designed and developed to use visual feedback to assess the ability of participants to accurately adjust limb placement or limb movement velocity and to encourage improvements in performance of these tasks. Each system was tested on participants with PD, age-matched control subjects and young control subjects to characterize and compare limb placement and velocity control capabilities. Results demonstrated that participants with PD were less accurate at placing their limbs than age-matched or young control subjects, but that their performance improved over the course of the test session such that by the end, the participants with PD performed as well as controls. For the limb velocity feedback task, participants with PD and age-matched control subjects were less accurate than young control subjects, but at the end of the session, participants with PD and age-matched control subjects were as accurate as the young control subjects. This study demonstrates that people with PD were able to improve their movement patterns based on visual feedback of performance and suggests that this feedback paradigm may be useful in exercise programs for people with PD.
ContributorsSmith, Catherine (Author) / Abbas, James J (Thesis advisor) / Ingalls, Todd (Thesis advisor) / Krishnamurthi, Narayanan (Committee member) / Buneo, Christopher (Committee member) / Rikakis, Thanassis (Committee member) / Arizona State University (Publisher)
Created2015
Description
Although tremor, rigidity, and bradykinesia are cardinal symptoms of Parkinson's disease (PD), impairments of gait and balance significantly affect quality of life, especially as the disease progresses, and do not respond well to anti-parkinsonism medications. Many studies have shown that people with PD can walk better when appropriate cues are presented but, to the best of our knowledge, the effects of real-time feedback of step length and uprightness of posture on gait and posture have not been specifically investigated. If it can be demonstrated that real-time feedback can improve posture and gait, the resultant knowledge could be used to design effective rehabilitation strategies to improve quality of life in this population.
In this feasibility study, we have developed a treadmill-based experimental paradigm to provide feedback of step length and upright posture in real-time. Ten subjects (mean age 65.9 ± 7.6 years) with mild to moderate PD (Hoehn and Yahr stage III or below) were evaluated in their ability to successfully utilize real-time feedback presented during quiet standing and treadmill walking tasks during a single data collection session in their medication-on state. During quiet standing tasks in which back angle feedback was provided, subjects were asked to utilize the feedback to maintain upright posture. During treadmill walking tasks, subjects walked at their self-selected speed for five minutes without feedback, with feedback of back angle, or with feedback of step length. During walking tasks with back angle feedback, subjects were asked to utilize the feedback to maintain upright posture. During walking tasks with step length feedback, subjects were asked to utilize the feedback to walk with increased step length. During quiet standing tasks, measurements of back angle were obtained; during walking tasks, measurements of back angle, step length, and step time were obtained.
Subjects stood and walked with significantly increased upright posture during the tasks with real-time back angle feedback compared to tasks without feedback. Similarly, subjects walked with significantly increased step length during tasks with real-time step length feedback compared to tasks without feedback. These results demonstrate that people with PD can utilize real-time feedback to improve upright posture and gait.
In this feasibility study, we have developed a treadmill-based experimental paradigm to provide feedback of step length and upright posture in real-time. Ten subjects (mean age 65.9 ± 7.6 years) with mild to moderate PD (Hoehn and Yahr stage III or below) were evaluated in their ability to successfully utilize real-time feedback presented during quiet standing and treadmill walking tasks during a single data collection session in their medication-on state. During quiet standing tasks in which back angle feedback was provided, subjects were asked to utilize the feedback to maintain upright posture. During treadmill walking tasks, subjects walked at their self-selected speed for five minutes without feedback, with feedback of back angle, or with feedback of step length. During walking tasks with back angle feedback, subjects were asked to utilize the feedback to maintain upright posture. During walking tasks with step length feedback, subjects were asked to utilize the feedback to walk with increased step length. During quiet standing tasks, measurements of back angle were obtained; during walking tasks, measurements of back angle, step length, and step time were obtained.
Subjects stood and walked with significantly increased upright posture during the tasks with real-time back angle feedback compared to tasks without feedback. Similarly, subjects walked with significantly increased step length during tasks with real-time step length feedback compared to tasks without feedback. These results demonstrate that people with PD can utilize real-time feedback to improve upright posture and gait.
ContributorsJellish, Jeremy (Author) / Abbas, James (Thesis advisor) / Krishnamurthi, Narayanan (Thesis advisor) / Ingalls, Todd (Committee member) / Arizona State University (Publisher)
Created2014