Spatiotemporal control in different movement and balance tasksin early Parkinson's disease

Bengevoord, A. (2014) Spatiotemporal control in different movement and balance tasksin early Parkinson's disease. thesis, Human Movement Sciences.

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Abstract

Objective: To investigate if spatiotemporal control in early patients with Parkinson's disease (PD) is limited to gait problems and if there are differences between tremor dominant (TD) and postural instability and gait disorder (PIGD) subtypes of PD in motor functioning in the early stage of the disease. Background: It has been found that specifically gait is affected in PD, probably as a result of a central defect in spatiotemporal control of locomotion in the brain. However, recent studies found a generalized defect in spatiotemporal motor control in PD and not only in gait. It is currently unclear if this generalized deficit is already present in early PD patients and whether this problem differentiates between different phenotypes of PD. Methods: Sixteen early PD patients (H&Y I-III, OFF medication) and 8 healthy age-matched controls were recruited in the context of a larger longitudinal study. Tremor and PIGD sub-scores of the MDSUPDRS were used to make a distinction between two subgroups: 8 patients were classified as TD and 8" as PIGD. All subjects performed 4 different movement tasks (gait, balance and repetitive movements of upper- and lower limbs). Outcome measures included spatial and temporal parameters and variability measures were investigated as well. Lower limb and pelvis movements were analyzed using the VICON 3D motion analysis system. Upper limb movements were analyzed by a shaft encoder recording kinematics of a fmger tapping movement. Results: Analyses of variance between early PD patients and age-matched healthy controls showed significantly worse dynamic balance, worse scores on different parameters of static balance and more variability in the amplitude of the bilateral finger tapping task in early PD patients compared to agematched healthy controls. Further comparisons between subtypes of PD showed that PIGD patients had more variability in stride time, lower frequencies in the disease dominant hand, more variability in velocity in the anterior-posterior (AP) direction of the non-dominant leg and higher scores on relative phase (RP) variance on the lower limb task compared to TD patients. All other parameters were equal between groups and subgroups. Conclusion: Coordination of repetitive movements and static balance seem to be the most vulnerable aspects of motor functioning in early PD. Other motor tasks showed no clear impairments in motor functioning in early PD patients. Differences between TD- and PIGD subgroups should be investigated in larger samples and adapted protocols should be used. More research is needed to confirm the validity of TD/PIGD sub-classification for patients with PD in early disease stages or to distinguish between different stages of PD.

Item Type:	Thesis (Thesis)
Supervisor name:	Supervision: and Kamsma, Y.P.T. and Nieuwboer, A. and Center for Human Movement Sciences, UMCG
Supervisor name:	Vervoort, G. and Department of Rehabilitation Sciences, KU Leuven
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:59
Last Modified:	25 Jun 2020 10:59
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1929

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