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It was found that the synergistic effect of stride length when passing through obstacles was low in patients with Parkinson’s disease.

An interdisciplinary research group at the Movi-Lab in the Faculty of Physical Education at the State University of Sao Paulo (UNESP) in Bauru, Brazil, measures the synergistic effect of stride length over obstacles in patients with Parkinson’s disease. , Concluded that he was 53 years old. % Less than healthy subjects of the same age and weight. Step length is one of the main variables affected by the disease.

Synergistic effects, defined as compound operations, in this case refer to the ability of the locomotor (or musculoskeletal) system to combine factors such as velocity and foot position to adapt movement as it crosses an obstacle. Improving synergies while a Parkinson’s patient is walking can make a significant difference in quality of life, as they are on average three times more likely to fall than healthy people of the same age.

Our athletic group has patients who fall 3-4 times a week. To improve the synergies of step lengths, it is important to understand how these patients’ gait and movement adapt over obstacles. This approach can improve exercise protocols, improve exercise, and reduce the frequency of falls. “

Fabio Augusto Barbieri, Professor of UNESP Faculty of Physical Education and its Graduate Program in Athletic Sciences

An article about research was published in the journal Walking and posture.. Barbieri is the last author. The lead author is Satyajit Ambike, a mechanical engineer who is a professor of health and exercise at Purdue University in the United States. This study is the first to report a disorder of exercise synergies in patients with Parkinson’s disease.

“The innovation in our research is focusing on the timing of walking, or rhythmicity, that is, the constantness that the patient puts his or her foot on to maintain exercise,” says Barbieri. “This can be assessed by measuring the synergies of step lengths. Synergies presuppose a goal and have to do with how the motor system adjusts to achieve it. In our case, movement. . “

Researchers have found that patients with Parkinson’s disease are less able to adapt their foot position than healthy people when approaching or overcoming obstacles. “The motor system constantly tries to adapt to maintain immutability during exercise. Without this immutability, you can make mistakes that can lead to falls,” Barbieri said. .. “Patients with Parkinson’s disease tend to have unstable foot positions during walking, resulting in unstable walking timing. The speed increases and decreases with walking, depending on the placement of the feet. The stride changes. “

Obstacle

Thirteen Parkinson’s disease patients and 11 neurologically healthy controls participated in the study. All participants were over 50 years old. To qualify, you can walk without assistance, have normal vision and hearing (with or without lenses and hearing aids), have no orthopedic or neurological disorders other than Parkinson’s disease, understand the instructions, and it To obey. Patients took Parkinson’s disease (levodopa) medication for at least 3 months prior to data collection.

Participants walked along the aisle (8.5 m long, 3.5 m wide) and walked through a foam rubber obstacle (15 cm high, 60 cm wide, 5 cm deep) 4 m from the starting point. I had to cross. No walking speed was imposed, but was chosen by each participant. There was no instruction as to which leg would cross the obstacle first, but the position was adjusted for each participant so that the right leg had to move forward.

“We tried to standardize the task so that all subjects would lead their right foot over obstacles,” Barbieri said. “The idea was to make sure there was no interference from other factors in the movement pattern. The height of the obstacle was 15 cm because it is the standard curb height in Brazil. I thought it was the best. “

He explained that many systems need to work together to achieve synergies in achieving their goals. “The distance between your toes and obstacles [before it is crossed] Between heels and obstacles [after it is crossed] It changes so much that it increases the risk of contact with obstacles. If you are too close to an obstacle before crossing, you will have to raise your front legs high, which can prove impossible. If the hind legs come too close to the obstacle after crossing, the heel is more likely to touch the obstacle, “he said, with ideally constant walking timing and the foot too close to the obstacle on either side. He added that it should not be.

Biomechanics

The synergistic effect of step length was measured using a methodology derived from mechanical engineering and adapted to the study of human movement. Although this methodology is not specific to gait analysis or Parkinson’s disease, it does employ a set of techniques used by Ambike and Mark Latash of Pennsylvania State University to measure upper limb muscle strength.

The eight motion capture cameras used in this study were purchased with funding from FAPESP (Grant Number 2017/19516-8). This research was also supported by a visiting researcher grant.

Twenty reflex markers were placed on the bodies of each participant in the experiment according to a specific gait analysis model. “While the subject walks across the aisle towards an obstacle, the camera emits infrared light that is reflected by the marker so that the camera can capture the position of the marker and determine stride length and duration. The gait analysis software also does other calculations, ”explains Barbieri.

According to Barbieri, this study was the first time this methodology was applied to gait analysis. “Another innovation is a more consistent future intervention to use a single variable to detect incompetence that may be related to gait timing relatively easily and improve gait timing through training. Was to make it easier, “he said. “This is the point of general gait analysis. We want to determine the variables that can change gait and change the intervention based on it.”

Since then, the same researchers have begun research to see if obstacle height affects the synergistic effect of step lengths. “I want to know if this synergistic effect changes depending on whether the obstacle is high or low. This is related to the environment in which the patient moves. Problems occur when there is a certain height of obstacle in the area. You can change the environment to make it easier to move because you can fall over. “

Source:

Journal reference:

Ambike, S. , et al. (2021) In patients with Parkinson’s disease, the synergistic effect of stride length while crossing obstacles is weak. Walking and posture. doi.org/10.1016/j.gaitpost.2021.01.002..

It was found that the synergistic effect of stride length when passing through obstacles was low in patients with Parkinson’s disease.

Source link It was found that the synergistic effect of stride length when passing through obstacles was low in patients with Parkinson’s disease.

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