|Support type:||Scholarships in Brazil - Doctorate|
|Effective date (Start):||April 01, 2017|
|Effective date (End):||April 30, 2021|
|Field of knowledge:||Health Sciences - Physical Education|
|Principal Investigator:||Fabio Augusto Barbieri|
|Home Institution:||Faculdade de Ciências (FC). Universidade Estadual Paulista (UNESP). Campus de Bauru. Bauru , SP, Brazil|
|Associated scholarship(s):||18/03146-0 - Gait initiation during stepping down a curb: anticipatory and reactive postural adjustments, BE.EP.DR|
The difficulty in gait initiation happens often in patients with Parkinson's disease (PD). The lack of anticipatory postural adjustments (APAs) occurring before the first step are the main causes of difficulties in this population, which is related to the common signs and symptoms in PD, such as akinesia and postural instability. The increase in motor complexity and cognitive and sensory demand may further damage the gait initiation in patients with PD. The aim of this study is to investigate the effects of the obstacle avoidance, dual tasking and sensory restriction during gait initiation in PD patients. A series of four studies will be developed. In the first study a systematic review will be conducted in order to determine the changes in parameters of center of pressure, APAs and spatiotemporal parameters during gait initiation in patients with PD. The other three studies will verify the effects of different heights of obstacle avoidance on the gait initiation, analyze the influence of cognitive overload and to determine the contribution of visual and proprioceptive information during gait initiation with and without obstacle avoidance in patients with PD. In each study 20 patients with PD and 20 neurologically healthy individuals will participate. Cognitive aspect will be evaluated in all participants and clinical aspects will be only assessed in patients with PD. Participants will be instructed to initiate the walking and go through a pathway 10m-long in preferred speed. The first two steps of each trial will be analyzed. The following parameters will be analyzed according to the purpose of each study: APAs, spatiotemporal parameters, muscle activity and gaze behavior. The parameters of interest will be compared by MANOVAs with factors according to the independent variables and questions of each study.