Article

The reduction of arm swing during gait is a frequent phenomenon in patients with
early Parkinson's disease (PD). However, the objective quantification of this
clinical sign using treadmill-based gait analysis has not been systematically
evaluated so far. We simultaneously measured ultrasound based limb kinematics and
spatiotemporal gait parameters during treadmill walking at different speeds in 21
early PD patients in Hoehn and Yahr (HY) stage I, 19 patients with bilateral PD
in HY stage II and 25 age-matched controls. Both PD groups showed a highly
significant reduction of the arm swing amplitude on the more affected body side
(MAS). Decomposing total arm swing resulted in a bilateral decrease of arm
retroversion in both PD groups, whereas anteversion was normal on the less
affected side of the HY I cohort. Early stage patients exhibited a highly
significant, almost threefold increase of the arm swing asymmetry index (I(A))
compared with controls. Reduced retroversion on the MAS and increased arm swing
I(A) were the independent variables with the closest association to disease
status in a multivariate logistic regression analysis. We conclude that
ultrasound based motion analysis during treadmill walking allows reliable
investigation of asymmetric arm movements in early PD patients which attenuate
with ongoing disease. Impaired active arm retroversion seems to be the earliest
sign of upper extremity dysfunction in parkinsonian gait. The measurement of limb
kinematics during treadmill gait can broaden our methodological line-up for the
analysis of complex motor programs in movement disorders.
CI - Copyright (c) 2011 Elsevier B.V. All rights reserved.

Langue : ANGLAIS