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Dynamic balance in elderly with Parkinson’s disease

Grant number: 05/03559-2
Support type:Scholarships in Brazil - Master
Effective date (Start): September 01, 2006
Effective date (End): March 31, 2008
Field of knowledge:Health Sciences - Physical Education
Principal Investigator:Lilian Teresa Bucken Gobbi
Grantee:Maria Joana Duarte Caetano
Home Institution: Instituto de Biociências (IB). Universidade Estadual Paulista (UNESP). Campus de Rio Claro. Rio Claro , SP, Brazil

Abstract

Morphofunctional changes related to the aging process can cause changes in the spatial and temporal parameters of gait, contributing to increase the fall probability in the elderly. Individuals with Parkinson’s disease (PD) show more marked changes in gait than healthy elderly, which are triggered also by the balance control deficits. These deficits reflect an error of the basal ganglia to keep motor plans ready for action, leading the PD patient to an increased risk of fall. All these factors probably explain the decreased independence in PD patients. Within this context, the major question driving this study is: how neurologically normal elderly and PD patients change their gait pattern in tasks with different dynamic balance demands? In order to answer this question, besides of free walking (FW), two more tasks are offered: walking under wide restriction (WWR – 20 cm) and walking on a beam (WB – 20 cm wide and 10 cm high). Then, the purpose of this study is to describe and to analyze kinematically the gait pattern of healthy elderly and PD patients during the performance of the tasks and to relate the spatial-temporal parameters and angular displacements with the individual characteristics: disease level (H&Y and UPDRS), recent falls (last year), and the score on Berg balance scale. Two groups of elderly over 60 years of age will be arranged: PD group with 15 individuals (levels 1 to 3 of H&Y) and control group: with 15 healthy elderly. Each participant will perform 15 trials for each task. A digital camcorder (trademark JVC, model GR-DVL9800) will be set in right sagittal plane in order to record a stride cycle in the medium of the pathway. The recorded images will be captured by a video board (trademark PINNACLE, model Studio DV, version 1.05.307) coupled a computer, creating 2D kinematics data. The Digital Video for Windows – DVIDEOW software will be used for photogrametric procedure and for the variables calculations the MATLAB (version 6.5) software will be used. The dependent variables of gait will be: stride length and time, toe clearance, cadence, mean velocity, time of swing and double support phases, and angular displacements of hip, knee and ankle. Qualitative analyses also will be done for trials by means of the captured images of an analogical camcorder (trademark SONY, model CCD-TRV40). This camcorder will be placed in the participant frontal plane in order to Record the feet placements and the trunk medium-lateral displacements during the tasks performance. The dependent variables will be treated by Analyses of Variance (ANOVA) with group (PD and control) and task (FW, WWR, WB) as factors and with repeated measures on the second factor. If significant differences among the tasks and the interactions will be revealed, the Tukey method will be applied to localize them. The significance level of p< 0.05 will be used for all the statistical analyses.

Scientific publications
(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)
DUARTE CAETANO, MARIA JOANA; BUCKEN GOBBI, LILIAN TERESA; DEL ROSARIO SANCHEZ-ARIAS, MONICA; STELLA, FLORINDO; GOBBI, SEBASTIAO. Effects of postural threat on walking features of Parkinson's disease patients. Neuroscience Letters, v. 452, n. 2, p. 136-140, MAR 13 2009. Web of Science Citations: 14.
Academic Publications
(References retrieved automatically from State of São Paulo Research Institutions)
CAETANO, Maria Joana Duarte. Equilíbrio dinâmico em idosos com doença de Parkinson. 2008. 82 f. Master's Dissertation - Universidade Estadual Paulita. Instituto de Biociências de Rio Claro. Rio Claro.

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