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Unrevealing the gait asymmetry in patients with Parkinson’s Disease: from the neural and motor mechanisms to rehabilitation: AsymmGait-Parkinson study


Gait asymmetry, along with variability, is directly related to more severe gait impairments, such as freezing, falls, and stumbling, in patients with Parkinson's disease (PD). Determining the neural mechanisms and causes of gait asymmetry in PD is relevant for the diagnosis and its pathogenesis. Also, considering that PD progression is related to motor asymmetry, knowing how to treat gait asymmetry is important to design rehabilitation strategies specific targeting this symptom. Thus, the purposes of this scientific project are to systematically review in the literature the effects of asymmetry in locomotion and its mechanisms in patients with PD; to determine clinical, personal, neural (size, shape and functionality of brain structures, and iron concentration determined by magnetic resonance imaging), blood (quantification of the concentration of the metallic particles) and motor factors associated with gait asymmetry in patients with PD; and to investigate the acute and chronic effect of motor and non-motor interventions on gait asymmetry in patients with PD. Five studies were designed to achieve the proposed aims: 1) a systematic review will be carried out to investigate the state of the art of gait asymmetry in patients with PD, answering the following question: How does PD asymmetry affect the neural and motor performance of gait in patients with PD?; 2) a cohort study will be performed to determine aspects that are related to gait asymmetry, highlighting mechanisms that explain this phenomenon; 3 and 4) two clinical trials will be performed to analyze the acute effect of motor and non-motor interventions on gait asymmetry in patients with PD. First, we will investigate whether an exercise protocol prioritizing the side most affected by PD reduces gait asymmetry. Then, we will investigate how a combination of exercise and intermittent hypoxia modifies gait asymmetry. These studies will guide a 5) 12-week intervention to verify the chronic effects of rehabilitation on gait asymmetry in patients with PD. The research project will elucidate the mechanisms that cause gait asymmetry in PD and assist in developing assertively strategies for gait asymmetry rehabilitation program. (AU)

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(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
FARIA, MURILO HENRIQUE; SIMIELI, LUCAS; RIETDYK, SHIRLEY; PENEDO, TIAGO; SANTINELLI, FELIPE BALISTIERI; BARBIERI, FABIO AUGUSTO. (A)symmetry during gait initiation in people with Parkinson's disease: A motor and cortical activity exploratory study. FRONTIERS IN AGING NEUROSCIENCE, v. 15, p. 11-pg., . (18/21870-7, 22/02971-2, 19/24752-8)

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