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Preparatory Postural Adjustments in Parkinsonian Patients with Postural Instability

Published online by Cambridge University Press:  18 September 2015

Robert G. Lee ,
Ida Tonolli ,
Francois Viallet ,
Roslyn Aurenty  and
Jean Massion
Robert G. Lee*
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary
Ida Tonolli
Affiliation:
Laboratoire de Neurobiologie et Mouvement CNRS, Marseille, France
Francois Viallet
Affiliation:
Laboratoire de Neurobiologie et Mouvement CNRS, Marseille, France
Roslyn Aurenty
Affiliation:
Laboratoire de Neurobiologie et Mouvement CNRS, Marseille, France
Jean Massion
Affiliation:
Laboratoire de Neurobiologie et Mouvement CNRS, Marseille, France
*
University of Calgary. Department of Clinical Neurosciences, 3330 Hospital Drive N.W.Calgary, Alberta, Canada T2N 4N1
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Abstract

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Background:

Postural instability is a common problem in patients with Parkinson’s disease. This paper reports results of a study undertaken to investigate some of the possible mechanisms responsible for this instability.

Methods:

Preparatory postural adjustments associated with a lateral leg raising task were studied in five parkinsonian patients and four age-matched controls. Recordings included ground reaction forces, kinematics, and surgace EMG activity from multiple leg muscles.

Results:

In normal subjects there was a well-defined sequence of events preceding the onset of leg elevation, beginning with a transfer of centre of foot pressure (CP), initially toward the moving leg and then back to the support side, followed by displacement of the trunk toward the support side. In the more severely affected parkinsonian patients, the amplitude of the the initial displacement of CP was markedly reduced. The interval between the earliest force changes and the onset of leg elevation was prolonged and the relative timing of the kenematic adjustments during this interval was disrupted. In addition the alternating burst and periods of inhibition observed in the EMG recordings from the normal subjects were replaced by continuous tonic EMG activity.

Conclusions:

These observations suggest that abnormalities in programming preparatory postural adjustments may contribute to postural instability in some patients with advanced Parkinson’s disease.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 22 , Issue 2 , May 1995 , pp. 126 - 135
Copyright
Copyright © Canadian Neurological Sciences Federation 1995

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