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Neurorehabilitation and Neural Repair
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*Movement Disorders
*Parkinson's Disease
*Patient Rights
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A Kinematic and Electromyographic Analysis of Turning in People With Parkinson Disease

Minna Hong, PhD, PT

Movement Science Program, Washington University School of Medicine, St. Louis, Missouri, Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, Program in Neurology, Washington University School of Medicine, St. Louis, Missouri

Joel S. Perlmutter, MD

Movement Science Program, Washington University School of Medicine, St. Louis, Missouri, Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, Program in Neurology, Washington University School of Medicine, St. Louis, Missouri, Anatomy and Neurobiology, Washington University School of Medicine, St. Louis, Missouri, Radiology, Washington University School of Medicine, St. Louis, Missouri

Gammon M. Earhart, PhD, PT

Movement Science Program, Washington University School of Medicine, St. Louis, Missouri, Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, Program in Neurology, Washington University School of Medicine, St. Louis, Missouri, Anatomy and Neurobiology, Washington University School of Medicine, St. Louis, Missouri, earhartg{at}msnotes.wustl.edu

Background. Parkinson disease frequently causes difficulty turning that can lead to falls, loss of independence, and diminished quality of life. Turning in tight spaces, which may be particularly impaired in Parkinson disease, is an essential part of our daily lives, yet a comprehensive analysis of in-place turning has not been published. Objective. This study was conducted to determine whether there are objective differences in turning between people with Parkinson disease and unimpaired people. Methods. In-place turning with kinematics and electromyographic measures was characterized in 11 participants with Parkinson disease and 12 healthy people. Kinematic data were recorded using a 3-dimensional motion capture system in synchrony with electromyographic data from lower extremity muscles as participants turned 180°. Those with Parkinson disease were tested after overnight withdrawal of medication. Results. Both groups used 2 distinct turning strategies. In one, the foot ipsilateral to the turning direction initiated the turn; in the other, the foot contralateral to the turning direction initiated the turn. Kinematic analysis demonstrated a craniocaudal sequence of turning in the unimpaired group, whereas those with Parkinson disease had a simultaneous onset of yaw rotation of the head, trunk, and pelvis. They also took a longer time and more steps to complete turns. Overall, lower extremity muscle activation patterns appeared similar between groups. Conclusion. Differences between the groups were noted for axial control, but lower extremity muscle patterns were similar. This work may provide the foundation for development of new treatments for turning difficulty in Parkinson disease.

Key Words: Turning • Parkinson disease • Electromyography • Kinematics

References

This version was published on February 1, 2009

Neurorehabilitation and Neural Repair, Vol. 23, No. 2, 166-176 (2009)
DOI: 10.1177/1545968308320639
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 Neurorehabil Neural RepairHome page
A. Nieuwboer, K. Baker, A.-M. Willems, D. Jones, J. Spildooren, I. Lim, G. Kwakkel, E. Van Wegen, and L. Rochester
The Short-Term Effects of Different Cueing Modalities on Turn Speed in People with Parkinson's Disease
Neurorehabil Neural Repair, October 1, 2009; 23(8): 831 - 836.
[Abstract] [PDF]

This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
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Services
Right arrow Email this article to a friend
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Right arrow Request Reprints
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Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Hong, M.
Right arrow Articles by Earhart, G. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hong, M.
Right arrow Articles by Earhart, G. M.
Right arrowPubmed/NCBI databases
Medline Plus Health Information
*Movement Disorders
*Parkinson's Disease
*Patient Rights
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
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