Article

The effect of levodopa on postural motor learning in people with
Parkinson's disease is poorly understood. In particular, it is unknown whether
levodopa affects improvement in protective postural responses after external
perturbations such as a slip or trip, a critical aspect of fall prevention.
Objective Determine the effect of levodopa on postural motor learning in people
with Parkinson's disease. Methods We assessed improvement in protective postural
responses in people with Parkinson's disease over short-term (1 day) perturbation
training on and off levodopa. We also assessed retention and generalization of
improvement. Participants were 22 individuals with Parkinson's disease. The
primary outcome was total center of mass (COM) displacement after perturbation.
Secondary outcomes assessed first step performance and included margin of
stability at first foot contact. Results People with Parkinson's disease improved
COM displacement (P = .011) and margin of stability (P = .016) over training.
Improvements in these outcomes were more pronounced after training while on
levodopa than off levodopa. Levodopa State x Training interactions were not
observed for other step performance variables (eg, step latency, length, total
number of steps). Improvements were retained for 24 hours, and for margin of
stability, retention was more pronounced while on levodopa than off (P = .018).
Conclusions Individuals with Parkinson's disease are able to improve protective
postural responses through short-term perturbation training, and improvements
were more pronounced when on levodopa for some variables. Perturbation training
may be more effective if completed while optimally medicated with levodopa.
CI - (c) The Author(s) 2016.

Langue : ANGLAIS