Backward walking in people with Parkinson's disease

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Backward walking in people with Parkinson's disease

 

Author: Lam, Ngo-sheung
Title: Backward walking in people with Parkinson's disease
Degree: M.Sc.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations.
Parkinson's disease -- Patients -- Rehabilitation
Parkinson's disease -- Treatment
Motor ability -- testing.
Walking -- Therapeutic use.
Department: Dept. of Rehabilitation Sciences
Pages: vi, 44 leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2301010
URI: http://theses.lib.polyu.edu.hk/handle/200/4655
Abstract: Background: Forward walking (FW) has been extensively studied in previous studies in patients with Parkinson's disease (PD), but in daily life a few steps of backward walking (BW) is also required in a lot of daily activities. Objectives: This study aimed to investigate the temporal and spatial parameters of BW in PD subjects, and to establish the relationship of balance performance and the gait parameters of BW. Methods: Seventeen PD subjects and thirteen control subjects completed the study. All subjects were instructed to walk along an electronic carpet in forward and backward directions. Gait parameters of comfortable speed FW and BW were assessed by GAITRite system. Performance-based balance tests including left and right one-leg stance test and functional reach test were done to assess their balance abilities. In addition Chinese translated Activities-Specific Balance Confidence (ABC) scale was used to assess their balance confidence. For the PD subjects, the Unified Parkinson's Disease Rating Scale (UPDRS) motor examination was also performed. All PD subjects were tested during their "on" medication. Results: When compared to control subjects, FW of PD subjects were characterized by significantly lower velocity (by 14.0%, p<0.001), shorter stride length (by 13.2%, p<0.019) and longer double support phase (by 14.2%; p<0.002). When the gait direction was changed from forward to backward, both PD and control groups had significantly decrease in velocity and stride length. However stride length was more reduced in PD than control subjects as reflected by group x direction interaction. As a result, PD group had significantly slower velocity (by 33.7%, p<0.001), and had marked reduced stride length (by 35.7%, p<0.000) than control subjects during BW. No significant difference was found in cadence between 2 groups in both FW and BW. Significant correlations were found between one-leg stance (OLS) time, forward reach (FR) distance and backward gait parameters: velocity, stride length, double support phase, ratio of BW to FW velocity and ratio of BW to FW stride length in PD group Discussion and conclusions: PD subjects walked with lower velocity and significantly shorter stride length in BW than in FW. Moreover relationship was found between balance performance and BW performance in PD subjects. BW may be usefully as an assessment procedure to reflect walking difficulty and balance deficits in patients with PD. Further study is needed to explore BW performance at different walking speed, during "off" medication, and the possibility of using BW for improving balance.

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