TY  - JOUR
A1  - Dipaola, Mariangela
A1  - Pavan, Esteban E.
A1  - Cattaneo, Andrea
A1  - Frazzitta, Giuseppe
A1  - Pezzoli, Gianni
A1  - Cavallari, Paolo
A1  - Frigo, Carlo A.
A1  - Isaias, Ioannis U.
T1  - Mechanical Energy Recovery during Walking in Patients with Parkinson Disease
JF  - PLoS ONE
N2  - The mechanisms of mechanical energy recovery during gait have been thoroughly investigated in healthy subjects, but never described in patients with Parkinson disease (PD). The aim of this study was to investigate whether such mechanisms are preserved in PD patients despite an altered pattern of locomotion. We consecutively enrolled 23 PD patients (mean age 64±9 years) with bilateral symptoms (H&Y ≥II) if able to walk unassisted in medication-off condition (overnight suspension of all dopaminergic drugs). Ten healthy subjects (mean age 62±3 years) walked both at their ‘preferred’ and ‘slow’ speeds, to match the whole range of PD velocities. Kinematic data were recorded by means of an optoelectronic motion analyzer. For each stride we computed spatio-temporal parameters, time-course and range of motion (ROM) of hip, knee and ankle joint angles. We also measured kinetic (Wk), potential (W\(_{p}\)), total (W\(_{totCM}\)) energy variations and the energy recovery index (ER). Along with PD progression, we found a significant correlation of W\(_{totCM}\) and W\(_{p}\) with knee ROM and in particular with knee extension in terminal stance phase. W\(_{k}\) and ER were instead mainly related to gait velocity. In PD subjects, the reduction of knee ROM significantly diminished both W\(_{p}\) and W\(_{totCM}\). Rehabilitation treatments should possibly integrate passive and active mobilization of knee to prevent a reduction of gait-related energetic components.
KW  - Parkinson disease
KW  - mechanical energy
KW  - kinematics
KW  - velocity
KW  - hip
KW  - gait analysis
KW  - walking
KW  - knees
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-179739
VL  - 11
IS  - 6
ER  - 
TY  - JOUR
A1  - Palmisano, Chiara
A1  - Brandt, Gregor
A1  - Vissani, Matteo
A1  - Pozzi, Nicoló G.
A1  - Canessa, Andrea
A1  - Brumberg, Joachim
A1  - Marotta, Giorgio
A1  - Volkmann, Jens
A1  - Mazzoni, Alberto
A1  - Pezzoli, Gianni
A1  - Frigo, Carlo A.
A1  - Isaias, Ioannis U.
T1  - Gait Initiation in Parkinson’s Disease: Impact of Dopamine Depletion and Initial Stance Condition
JF  - Frontiers in Bioengineering and Biotechnology
N2  - Postural instability, in particular at gait initiation (GI), and resulting falls are a major determinant of poor quality of life in subjects with Parkinson’s disease (PD). Still, the contribution of the basal ganglia and dopamine on the feedforward postural control associated with this motor task is poorly known. In addition, the influence of anthropometric measures (AM) and initial stance condition on GI has never been consistently assessed. The biomechanical resultants of anticipatory postural adjustments contributing to GI [imbalance (IMB), unloading (UNL), and stepping phase) were studied in 26 unmedicated subjects with idiopathic PD and in 27 healthy subjects. A subset of 13 patients was analyzed under standardized medication conditions and the striatal dopaminergic innervation was studied in 22 patients using FP-CIT and SPECT. People with PD showed a significant reduction in center of pressure (CoP) displacement and velocity during the IMB phase, reduced first step length and velocity, and decreased velocity and acceleration of the center of mass (CoM) at toe off of the stance foot. All these measurements correlated with the dopaminergic innervation of the putamen and substantially improved with levodopa. These results were not influenced by anthropometric parameters or by the initial stance condition. In contrast, most of the measurements of the UNL phase were influenced by the foot placement and did not correlate with putaminal dopaminergic innervation. Our results suggest a significant role of dopamine and the putamen particularly in the elaboration of the IMB phase of anticipatory postural adjustments and in the execution of the first step. The basal ganglia circuitry may contribute to defining the optimal referent body configuration for a proper initiation of gait and possibly gait adaptation to the environment.
KW  - gait initiation
KW  - Parkinson’s disease
KW  - basal ganglia
KW  - dopamine
KW  - base of support
KW  - anthropometric measurements
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-200801
SN  - 2296-4185
VL  - 8
ER  -