Eikelboom, C. (Charlotte) (2018) Forward arm extension improves gait initiation in Parkinson’s patients. thesis, Medicine.
Full text available on request.Abstract
Introduction: Disturbed gait in patients with Parkinson’s disease (PD) is characterized by small steps, loss of arm swing and starting problems. Such disturbed motor initiation and impaired multi-limb movements may reflect impaired function of the supplementary motor area (SMA). We hypothesized improved starting by forward arm extension at gait initiation, serving as a cue to reduce freezing of gait (FOG). Materials and methods: The effect of forward arm extension was measured with distance markers, video recordings, stopwatch recordings and inertial measurement units (IMUs) in 20 PD patients while walking a six meter trajectory under two conditions: gait initiation with and without arm extension. Results: The first two meters of walking was covered significantly faster with compared to no arm extension at gait initiation, as derived from video recordings. Stopwatch recordings were not accurate enough to confirm this finding. We additionally observed that the first two steps with arm extension took longer than without and the initial step length was larger. The time of first heel strike and first toe-off did not differ between conditions. Lastly, 6 of 20 participants reported preference of gait initiation with arm extension. Discussion: A shorter time to cover an initial walking distance, without difference in time of first toe-off and heel strike, suggests that this improvement is not due to a faster onset of the SMA. It may likely be explained by shifting the center of gravity ahead of the patient causing a forward foot placement. This simple task can be used besides other FOG reduction cues. In conclusion, forward arm extension improves gait initiation in PD.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor 1: and Maurits, Prof. dr. ir. NM and Supervisor 2: and Jong, Dr. BM de and Institution / department: UMCG, Neurology |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:04 |
| Last Modified: | 25 Jun 2020 11:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2415 |
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