Pathomechanics of parkinson disease gait

parkinson disease gait include festinating gait or shuffling gait

1. PATHOMICHANICS OF PARKINSON DISEASE GAIT BY: JWANIKA VANSIYA

2. What is P arkinson’s disease? Parkinson’s disease is a progressive neurological condition , resulting from the degeneration of dopamine producing neurones in the substantia nigra , which is located within the basal ganglia, deep in the lower region of the brain, on either side of the brain stem.

3. . Bradykinesia Rigidity Tremor Postural instability Clinical features

4. . Also called P arkinsonian gait or Festinating gait. Parkinsonian gait is characterized by small shuffling  steps  and a general slowness of movement ( hypokinesia ), or even the total loss of movement ( akinesia ) in the extreme cases. Parkinson disease gait

5. . Tottering gait Characteristically shows difficulty in initiating gait, rapid short shuffling steps with loss of arm swing, stooped stance propulsion. Turning or changing direction is particularly difficult and typically accompanied by taking multiple small steps. Parkinsonian Gait.mp4 Festinating gait

6. . Freezing of Gait (FOG) is typically a transient episode – lasting less than a minute, in which gait is halted and the patient complains that his/her feet are glued to the ground . ‘ ignition disturbances’ Falls Falls result mainly due to sudden changes in posture, in particular turning movements of the trunk, or attempts to perform more than one activity simultaneously with walking or balancing Freezing of gait (FOG)

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8. . Velocity (m/s) Stride length (m) Cadence (stride/min) Double support time Cycle time ( s) Spatiotemporal parameters

9. . Normal Early stance – Dorsiflexion to planterflexion Mid stance- Dorsiflexion Late stance- Planter flexion Parkinsonian gait Reduction in dorsiflexion ROM at early stance. Reduction in planter flexion ROM during toe off. Kinematics data A nkle

10. . Normal Early to mid stance-Extension to 15 degree of flexion Late stance- knee flexion with planter flexion Parkinsonian gait Reduced knee extension during single support stance. Kinematics data knee

11. . Normal Early to mid stance phase – flexion Late stance phase – extension Parkinsonian gait Lower flexion range during initial contact Decrease hip flexion ROM in pre swing phase. Kinematics data Hip

12. Ankle : Reduced ankle moment at loading response. Power generation in parkinson disease group deteriorate in late stance. Knee: Lower power generation during single stance phase of the gait. This occurs due to limited knee extension during the stance phase. Decreased power absorption at the knee joint during the late stance and preswing phase. Kinetics data

13. Hip Reduction of max hip extensor moment and decrease hip power generation in the first double support. Also max hip flexion moment and power generation in the second double support and pre swing reduced. Parkinsonian Gait Demonstration.mp4

14. References Sofuwa O, Nieuwboer A, Desloovere K, Willems AM, Chavret F, Jonkers I. Quantitative gait analysis in Parkinson's disease: comparison with a healthy control group. Archives of physical medicine and rehabilitation. 2005;86(5):1007-13. Svehlik M, Zwick EB, Steinwender G, Linhart WE, Schwingenschuh P, Katschnig P, et al. Gait analysis in patients with Parkinson's disease off dopaminergic therapy. Archives of physical medicine and rehabilitation. 2009;90(11):1880-6 . Svehlik M, Zwick EB, Steinwender G, Linhart WE, Schwingenschuh P, Katschnig P, et al. Gait analysis in patients with Parkinson's disease off dopaminergic therapy. Archives of physical medicine and rehabilitation. 2009;90(11):1880-6.

15. Gait disorders evaluation and management J effrey M. Hausdorff , Neil B. Alexander The Professional’s Guide to Parkinson’s Disease