Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2014 Jan 13;9(1):e84245.
doi: 10.1371/journal.pone.0084245. eCollection 2014.

Factors influencing obstacle crossing performance in patients with Parkinson's disease

Ying-Yi Liao  1 , Yea-Ru Yang  2 , Yih-Ru Wu  3 , Ray-Yau Wang  2
Affiliations
Clinical Trial

Factors influencing obstacle crossing performance in patients with Parkinson's disease

Ying-Yi Liao et al. PLoS One. .

Abstract

Background: Tripping over obstacles is the major cause of falls in community-dwelling patients with Parkinson's disease (PD). Understanding the factors associated with the obstacle crossing behavior may help to develop possible training programs for crossing performance. This study aimed to identify the relationships and important factors determining obstacle crossing performance in patients with PD.

Methods: Forty-two idiopathic patients with PD (Hoehn and Yahr stages I to III) participated in this study. Obstacle crossing performance was recorded by the Liberty system, a three-dimensional motion capture device. Maximal isometric strength of the lower extremity was measured by a handheld dynamometer. Dynamic balance and sensory integration ability were assessed using the Balance Master system. Movement velocity (MV), maximal excursion (ME), and directional control (DC) were obtained during the limits of stability test to quantify dynamic balance. The sum of sensory organization test (SOT) scores was used to quantify sensory organization ability.

Results: Both crossing stride length and stride velocity correlated significantly with lower extremity muscle strength, dynamic balance control (forward and sideward), and sum of SOT scores. From the regression model, forward DC and ankle dorsiflexor strength were identified as two major determinants for crossing performance (R(2) = .37 to.41 for the crossing stride length, R(2) = .43 to.44 for the crossing stride velocity).

Conclusions: Lower extremity muscle strength, dynamic balance control and sensory integration ability significantly influence obstacle crossing performance. We suggest an emphasis on muscle strengthening exercises (especially ankle dorsiflexors), balance training (especially forward DC), and sensory integration training to improve obstacle crossing performance in patients with PD.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Obstacle crossing parameters.
See this image and copyright information in PMC

References

    1. Stolze H, Klebe S, Zechlin C, Baecker C, Friege L, et al. (2004) Falls in frequent neurological diseases–prevalence, risk factors and aetiology. J Neurol 251: 79–84. - PubMed
    1. Ashburn A, Stack E, Pickering RM, Ward CD (2001) A community-dwelling sample of people with Parkinson's disease: characteristics of fallers and non-fallers. Age Ageing 30: 47–52. - PubMed
    1. Galna B, Murphy AT, Morris ME (2010) Obstacle crossing in people with Parkinson's disease: foot clearance and spatiotemporal deficits. Hum Mov Sci 29: 843–852. - PubMed
    1. Stegemoller EL, Buckley TA, Pitsikoulis C, Barthelemy E, Roemmich R, et al. (2012) Postural instability and gait impairment during obstacle crossing in Parkinson's disease. Arch Phys Med Rehabil 93: 703–709. - PubMed
    1. Nallegowda M, Singh U, Handa G, Khanna M, Wadhwa S, et al. (2004) Role of sensory input and muscle strength in maintenance of balance, gait, and posture in Parkinson's disease: a pilot study. Am J Phys Med Rehabil 83: 898–908. - PubMed

Publication types