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Effects of Freezing of Gait and Visual Information on the Static Postural Control Ability in Patients with Parkinson's Disease

  • Kim, Jung Yee (Department of Taekwondo, Graduate School of Dong-A University) ;
  • Son, Min Ji (Department of Medicine, Graduate School of Dong-A University) ;
  • Kim, You Kyung (Department of Taekwondo, Graduate School of Dong-A University) ;
  • Lee, Meoung Gon (Department of Health Science, Graduate School of Dong-A University) ;
  • Kim, Jin Hee (Department of Health Science, Graduate School of Dong-A University) ;
  • Youm, Chang Hong (Department of Health Care and Science, College of Health Sciences, Dong-A University)
  • Received : 2016.08.09
  • Accepted : 2016.09.13
  • Published : 2016.09.30

Abstract

Objective: The purpose of this study was to analyze the effects of freezing of gait and visual information on the static postural control ability in patients with Parkinson's Disease (PD) during the bipedal stance with feet together. Method: This study included a total of 36 patients with PD; the freezer group included 17 PD patients (age: $69.3{\pm}6.2yrs$, height: $159.6{\pm}9.0cm$, weight: $63.4{\pm}9.78kg$) and the nonfreezer group included 19 PD patients (age: $71.4{\pm}5.6yrs$, height: $155.8{\pm}7.1cm$, weight: $57.7{\pm}8.6kg$). Static postural control ability was analyzed using variables of center of pressure (COP) and dividing by mediolateral, anteroposterior, and integration factors during a bipedal stance with the eyes open and closed. Results: Freezers and nonfreezers showed increases in anteroposterior velocity, mediolateral velocity, averaged velocity, and mediolateral 95% edge frequency when visual information was blocked. Additionally, freezers had greater anteroposterior range, 95% confidence ellipse area, and COP anteroposterior mean position than nonfreezers. Conclusion: Freezers and nonfreezers showed a reduction in static postural control ability when visual information was blocked. Additionally, the results of this study found a significant difference in static postural control ability between freezers and nonfreezers with PD. In particular, anteroposterior range, 95% confidence ellipse area, and COP anteroposterior mean position might be used to distinguish between freezers and nonfreezers with PD.

Keywords

References

  1. Abarbanel, H. D., Gills, Z., Liu, C. & Roy, R. (1996). Nonlinear-time-series analysis of chaotic laser dynamics. Physical Review A, 53(1), 440. https://doi.org/10.1103/PhysRevA.53.440
  2. Ahn, W. H., Ahn, J. S. & Park, E. K. (2009). The functional effect of multidirectional exercise program in Parkinson disease patients. Journal of Sport and Leisure Studies, 35(2), 791-799.
  3. Bartels, A. L. & Leenders, K. L. (2009). Parkinson's disease: the syndrome, the pathogenesis and pathophysiology. Cortex, 45(8), 915-921. https://doi.org/10.1016/j.cortex.2008.11.010
  4. Blaszczyk, J., Orawiec, R., Duda-Klodowska, D. & Opala, G. (2007). Assessment of postural instability in patients with Parkinson's disease. Experimental Brain Research, 183(1), 107-114. https://doi.org/10.1007/s00221-007-1024-y
  5. Bloem, B. R., Hausdorff, J. M., Visser, J. E. & Giladi, N. (2004). Falls and freezing of gait in Parkinson's disease: a review of two interconnected, episodic phenomena. Movement Disorders, 19(8), 871-884. https://doi.org/10.1002/mds.20115
  6. Byl, N. N., Nagarajan, S. S., Merzenich, M. M., Roberts, T. & McKenzie, A. (2002). Correlation of clinical neuromusculoskeletal and central somatosensory performance: variability in controls and patients with severe and mild focal hand dystonia. Neural Plasticity, 9(3), 177-203. https://doi.org/10.1155/NP.2002.177
  7. Centers for Disease Control & Prevention. (2008). Prevalence and research of Parkinson's disease. Centers for Disease Control & Prevention.
  8. Chastan, N., Debono, B., Maltete, D. & Weber, J. (2008). Discordance between measured postural instability and absence of clinical symptoms in Parkinson's disease patients in the early stages of the disease. Movement Disorders, 23(3), 366-372. https://doi.org/10.1002/mds.21840
  9. Dauer, W. & Przedborski, S. (2003). Parkinson's disease: mechanisms and models. Neuron, 39(6), 889-909. https://doi.org/10.1016/S0896-6273(03)00568-3
  10. de Lau, L. M. & Breteler, M. (2006). Epidemiology of Parkinson's disease. The Lancet Neurology, 5(6), 525-535. https://doi.org/10.1016/S1474-4422(06)70471-9
  11. Dolye, R. J., Hsiao-Wecksler, E. T., Ragan, B. G. & Rosengren, K. S. (2007). Generalizability of center of pressure measures of quiet standing. Gait & Posture, 25, 166-171. https://doi.org/10.1016/j.gaitpost.2006.03.004
  12. Donker, S. F., Roerdink, M., Greven, A. J. & Beek, P. J. (2007). Regularity of center-of-pressure trajectories depends on the amount of attention invested in postural control. Experimental Brain Research, 181(1), 1-11. https://doi.org/10.1007/s00221-007-0905-4
  13. Duncan, R. P., Leddy, A. L., Cavanaugh, J. T., Dibble, L. E., Ellis, T. D., Ford, M. P. ... & Earhart, G. M. (2015). Balance differences in people with Parkinson disease with and without freezing of gait. Gait & Posture, 42(3), 306-309. https://doi.org/10.1016/j.gaitpost.2015.06.007
  14. Giladi, N., Shabtai, H., Simon, E. S., Biran, S., Tal, J. & Korczyn, A. D. (2000). Construction of freezing of gait questionnaire for patients with Parkinsonism. Parkinsonism and Related Disorders, 6(3), 165-170. https://doi.org/10.1016/S1353-8020(99)00062-0
  15. Goetz, C. G., Poewe, W., Rascol, O., Sampaio, C., Stebbins, G. T., Counsell, C. & Seidl, L. (2004). Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations the Movement Disorder Society Task Force on rating scales for Parkinson's disease. Movement Disorders, 19(9), 1020-1028. https://doi.org/10.1002/mds.20213
  16. Grassberger, P. & Procaccia, I. (1983). Characterization of strange attractor. Physical Review Letters, 50, 346-349. https://doi.org/10.1103/PhysRevLett.50.346
  17. Harbourne, R. T. & Stergiou, N. (2009). Movement variability and the use of nonlinear tools: principles to guide physical therapist practice. Physical Therapy, 89(3), 267-282. https://doi.org/10.2522/ptj.20080130
  18. Horak, F. B., Dimitrova, D. & Nutt, J. G. (2005). Direction-specific postural instability in subjects with Parkinson's disease. Experimental Neurology, 193(2), 504-521. https://doi.org/10.1016/j.expneurol.2004.12.008
  19. Jankovic, J. (2007). Pathophysiology and assessment of parkinsonian symptoms and signs. In: Pahwa R, Lyons K, Koller WC, eds. Handbook of Parkinson' disease. New York: Taylor and Francis Group, LLC, 79-104.
  20. Kim, C. H., Kim, M. Y. & Lim, B. O. (2015). A Literature Review of Parkinson's Disease Rating, Balance, Fall and Gait Scales. Korean Journal of Sport Biomechanics, 25(4), 441-451. https://doi.org/10.5103/KJSB.2015.25.4.441
  21. Kwon, Y. C. & Park, J. H. (1989). Standardization of korean version of the Mini-Mental State Examination (MMSE-K) for Use in the Elderly. Part II. Diagnostic Validity. The Korean Neuropsychiatric Association, 28(3), 508-513.
  22. Lee, D. J. & Ko, T. S. (2010). Relationships between symptoms of depression and cognitive function, physical functions, and activities of dailyliving in stroke patients. Journal of Special Education & Rehabilitation Science, 49(4), 159-178.
  23. Lee, K. H. & Youm, C. H. (2015). Comparison of Taekwondo Levels and Gender Differences on Postural Control Ability in the Elementary Students Using Nonlinear Analysis. The Korean Journal of Physical Education-Natural Science, 54(3), 551-562.
  24. Merzenich, M. M. & Jenkins, W. M. (1993). Reorganization of cortical representations of the hand following alterations of skin inputs induced by nerve injury, skin island transfers, and experience. Journal of Hand Therapy, 6(2), 89-104. https://doi.org/10.1016/S0894-1130(12)80290-0
  25. Moore, O., Peretz, C. & Giladi, N. (2007). Freezing of gait affects quality of life of peoples with Parkinson's disease beyond its relationships with mobility and gait. Movement Disorders, 22(15), 2192-2195. https://doi.org/10.1002/mds.21659
  26. Moore, D. J., West, A. B., Dawson, V. L. & Dawson, T. M. (2005). Molecular pathophysiology of Parkinson's disease. Annual Review of Neuroscience, 28, 57-87. https://doi.org/10.1146/annurev.neuro.28.061604.135718
  27. Movement Disorder Society Task Force on Rating Scales for Parkinson's Disease. (2003). The Unified Parkinson's Disease Rating Scale (UPDRS): status and recommendations. Movement Disorders, 18(7), 738. https://doi.org/10.1002/mds.10473
  28. Nieuwboer, A., Rochester, L., Herman, T., Vandenberghe, W., Emil, G. E., Thomaes, T. & Giladi, N. (2009). Reliability of the new freezing of gait questionnaire: agreement between patients with Parkinson's disease and their carers. Gait & Posture, 30(4), 459-463. https://doi.org/10.1016/j.gaitpost.2009.07.108
  29. Nudo, R. J., Milliken, G. W., Jenkins, W. M. & Merzenich, M. M. (1996). Use-dependent alterations of movement representations in primary motor cortex of adult squirrel monkeys. Journal of Neuroscience, 16(2), 785-807. https://doi.org/10.1523/JNEUROSCI.16-02-00785.1996
  30. Nussbaum, R. L. & Ellis, C. E. (2003). Alzheimer's disease and Parkinson's disease. New England Journal of Medicine, 348(14), 1356-1364. https://doi.org/10.1056/NEJM2003ra020003
  31. Oh, H. J., Youm, C. H. & Kim, T. H. (2011). Effects of Exercise-Induced Fatigue and Blocked Vision on Postural Control during Upright Stance. Korean Journal of Sport Biomechanics, 21(3), 353-359. https://doi.org/10.5103/KJSB.2011.21.3.353
  32. Parkinson, J. (2002). An Essay on the Shaking Palsy. Journal of Neuropsychiatry, 14(2), 223-236. https://doi.org/10.1176/jnp.14.2.223
  33. Park, J. H., Son, K. & Kim, K. H. (2007). Chaos Analysis of Major Joint Motions for Young Males During Walking. Transactions of the Korean Society of Mechanical Engineers A, 31(8), 889-895. https://doi.org/10.3795/KSME-A.2007.31.8.889
  34. Pelykh, O., Klein, A. M., Botzel, K., Kosutzka, Z. & Ilmberger, J. (2015). Dynamics of postural control in Parkinson patients with and without symptoms of freezing of gait. Gait & Posture, 42(3), 246-250. https://doi.org/10.1016/j.gaitpost.2014.09.021
  35. Raymakers, J. A., Samson, M. M. & Verhaar, H. J. J. (2005). The assessment of body sway and the choice of the stability parameter(s). Gait & Posture, 21(1), 48-58. https://doi.org/10.1016/j.gaitpost.2003.11.006
  36. Schaafsma, J. D., Balssh, Y., Gurevich, T., Bartels, A. L., Hausdorff, J. M. & Giladi, N. (2003). Characterization of freezing of gait subtypes and the response of each to levodopa in Parkinson's disease. European Journal of Neurology, 10(4), 391-398. https://doi.org/10.1046/j.1468-1331.2003.00611.x
  37. Schieppati, M. & Nardone, A. (1991). Free and supported stance in Parkinson's disease. Brain, 114(3), 1227-1244. https://doi.org/10.1093/brain/114.3.1227
  38. Sturnieks, D. L., St George, R. & Lord, S. R. (2008). Balance disorders in the elderly. Neurophysiologie Clinique/Clinical Neurophysiology, 38(6), 467-478. https://doi.org/10.1016/j.neucli.2008.09.001
  39. Schmit, J. M., Riley, M. A., Dalvi, A., Sahay, A., Shear, P. K., Shockley, K. D. & Pun, R. Y. (2006). Deterministic center of pressure patterns characterize postural instability in Parkinson's disease. Experimental Brain Research, 168(3), 357-367. https://doi.org/10.1007/s00221-005-0094-y
  40. Vervoort, G., Nackaerts, E., Mohammadi, F., Heremans, E., Verschueren, S., Nieuwboer, A. & Vercruysse, S. (2013). Which aspects of postural control differentiate between patients with Parkinson's disease with and without freezing of gait?. Parkinson's Disease, 2013.
  41. Wolf, A., Swift, J. B., Swinney, H. L. & Vastano, J. A. (1985). Determining Lyapunov exponents from a time series. Physica D: Nonlinear Phenomena, 16(3), 285-317. https://doi.org/10.1016/0167-2789(85)90011-9
  42. Youm, C. H., Park, Y. H. & Seo, K. W. (2008). Assessment of Single-leg Stance Balance Using COP 95% Confidence Ellipse Area. Korean Journal of Sport Biomechanics, 18(2), 19-27. https://doi.org/10.5103/KJSB.2008.18.2.019

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