Action Observation Plus Sonification. Biomechanical Analysis of Sit-To-Walk Performance in Patients with Parkinson's Disease and Freezing of Gait

Susanna Mezzarobba, Michele Grassi, Lorella Pellegrini, Mauro Catalan, Björn Krüger, Lara Stragapede, Paolo Manganotti und Paolo Bernardis
In: Parkinsonism & Related Disorders (2020), 80(133-137)
 

Abstract

Introduction. Freezing of gait (FoG) is one of the most disabling gait disorders in Parkinson's disease (PD) reflecting motor and cognitive impairments, mainly related to dopamine deficiency. Recent studies, investigating kinematic and kinetic factors affecting gait in these patients, showed a postural instability characterized by disturbed weight-shifting, inappropriate anticipatory postural adjustment, worse reactive postural control, and a difficulty to execute complex motor task (i.e. sit-to-walk). Symptoms that are difficult to alleviate and not much responsive to Levodopa. For this reason, additional therapeutic actions based on specific therapeutic protocols may help patients in daily life. Methods. In 2018, we conducted a randomized control trial aimed to test two clinical protocols for PD patients with FoG. Protocols, conceived to improve gait, were based on learning motor exercises with the Action Observation plus Sonification (AOS) technique, and with a standard protocol centered on cue use. We found a significant improvement in the FoG questionnaire and the UPDRS III clinical scale for the AOS protocol only. We also collected biomechanical data, using the sit-to-walk task as a measure of motor performance. Results. Here we report kinetic and kinematic analysis of data showing that, when treatment effects consolidate, patients treated with AOS protocol are more efficient in merging subsequent motor tasks (sit-tostand and gait initiation) with a better dynamic balance control during the sit-to-stand. Conclusion. Promising results of the AOS protocol in reducing FoG confirm that a mobility training focused on improving weight-shifting and motor switching abilities, may have benefits for Parkinson patients with FoG.

Stichwörter: Action observation, Freezing of gait, Parkinson’s disease, Postural instability, Sit to walk

Bilder

Bibtex

@ARTICLE{Mezzarobba2020,
    author = {Mezzarobba, Susanna and Grassi, Michele and Pellegrini, Lorella and Catalan, Mauro and Kr{\"u}ger,
              Bj{\"o}rn and Stragapede, Lara and Manganotti, Paolo and Bernardis, Paolo},
     pages = {133--137},
     title = {Action Observation Plus Sonification. Biomechanical Analysis of Sit-To-Walk Performance in Patients
              with Parkinson's Disease and Freezing of Gait},
   journal = {Parkinsonism {\&} Related Disorders},
    volume = {80},
      year = {2020},
  keywords = {Action observation, Freezing of gait, Parkinson’s disease, Postural instability, Sit to walk},
  abstract = {Introduction. Freezing of gait (FoG) is one of the most disabling gait disorders in Parkinson's
              disease (PD) reflecting motor and cognitive impairments, mainly related to dopamine deficiency.
              Recent studies, investigating kinematic and kinetic factors affecting gait in these patients, showed
              a postural instability characterized by disturbed weight-shifting, inappropriate anticipatory
              postural adjustment, worse reactive postural control, and a difficulty to execute complex motor task
              (i.e. sit-to-walk). Symptoms that are difficult to alleviate and not much responsive to Levodopa.
              For this reason, additional therapeutic actions based on specific therapeutic protocols may help
              patients in daily life.
              Methods. In 2018, we conducted a randomized control trial aimed to test two clinical protocols for
              PD patients with FoG. Protocols, conceived to improve gait, were based on learning motor exercises
              with the Action Observation plus Sonification (AOS) technique, and with a standard protocol centered
              on cue use. We found a significant improvement in the FoG questionnaire and the UPDRS III clinical
              scale for the AOS protocol only. We also collected biomechanical data, using the sit-to-walk task as
              a measure of motor performance.
              Results. Here we report kinetic and kinematic analysis of data showing that, when treatment effects
              consolidate, patients treated with AOS protocol are more efficient in merging subsequent motor tasks
              (sit-tostand and gait initiation) with a better dynamic balance control during the sit-to-stand.
              Conclusion. Promising results of the AOS protocol in reducing FoG confirm that a mobility training
              focused on improving weight-shifting and motor switching abilities, may have benefits for Parkinson
              patients with FoG.},
       doi = {https://doi.org/10.1016/j.parkreldis.2020.09.029}
}