Discussion of Research Priorities for Gait Disorders in Parkinson's Disease

Abstract Background: Gait disorders in individuals with Parkinson’s Disease (PD) may be associated with alterations in the motor control system and aggravated by psychoemotional and cognitive issues. Therapeutic strategies aimed at self-perception and motor regulation seem to be promising. Motor imagery (MI) has been shown to be one of these strategies, but there is still no clear evidence of its applicability in this population. The aim of this trial is to determine the effects of motor imagery training on the gait and electroencephalographic activity of individuals with PD. Methods: The sample consisted of 40 individuals, aged between 45 and 75 years, in the mild and moderate phase of the disease, with the ability to generate voluntary mental images. They will be assessed for cognitive level, degree of physical disability, mental image clarity, kinematic gait variables, electroencephalographic activity and mobility. Next, subjects will be randomly assigned to an experimental (EG) and control group (CG). The EG will perform motor imagery and gait, while the CG will only engage in gait exercises. Twelve training sessions will be conducted lasting up to 90 minutes each, 3 times a week, for 4 weeks. They will be reassessed on the kinematic variables of gait, electroencephalographic activity and mobility, one, seven and thirty days after the final training session. Discussion: The results may provide an important advance in neurological rehabilitation. An easy-access and low-cost intervention may help improve gait, electroencephalographic activity and mobility in individuals with PD. Trial Registration: Clinicaltrials.gov: NCT03439800. Registered 15 November 2017. Keywords: Parkinson’s disease; Rehabilitation; Cerebral activation; Neurological gait disorders.

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Muscle Synergies in Parkinson’s Disease

Sensors ◽

10.3390/s20113209 ◽

2020 ◽

Vol 20 (11) ◽

pp. 3209 ◽

Cited By ~ 1

Author(s):

Ilaria Mileti ◽

Alessandro Zampogna ◽

Alessandro Santuz ◽

Francesco Asci ◽

Zaccaria Del Prete ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Experimental Studies ◽

Theoretical Background ◽

Gait Disorders ◽

Muscle Synergy ◽

Physiological Data ◽

Muscle Synergies ◽

Motor Symptoms ◽

Physiological Basis

Over the last two decades, experimental studies in humans and other vertebrates have increasingly used muscle synergy analysis as a computational tool to examine the physiological basis of motor control. The theoretical background of muscle synergies is based on the potential ability of the motor system to coordinate muscles groups as a single unit, thus reducing high-dimensional data to low-dimensional elements. Muscle synergy analysis may represent a new framework to examine the pathophysiological basis of specific motor symptoms in Parkinson’s disease (PD), including balance and gait disorders that are often unresponsive to treatment. The precise mechanisms contributing to these motor symptoms in PD remain largely unknown. A better understanding of the pathophysiology of balance and gait disorders in PD is necessary to develop new therapeutic strategies. This narrative review discusses muscle synergies in the evaluation of motor symptoms in PD. We first discuss the theoretical background and computational methods for muscle synergy extraction from physiological data. We then critically examine studies assessing muscle synergies in PD during different motor tasks including balance, gait and upper limb movements. Finally, we speculate about the prospects and challenges of muscle synergy analysis in order to promote future research protocols in PD.

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