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Muscle activation strategies of people with early-stage Parkinson’s during walking

Authors
  • Keloth, Sana M.1
  • Arjunan, Sridhar P.2
  • Raghav, Sanjay3
  • Kumar, Dinesh Kant1
  • 1 RMIT University,
  • 2 SRM Institute of Science and Technology,
  • 3 Monash Health,
Type
Published Article
Journal
Journal of NeuroEngineering and Rehabilitation
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Sep 08, 2021
Volume
18
Identifiers
DOI: 10.1186/s12984-021-00932-1
PMID: 34496882
PMCID: PMC8425033
Source
PubMed Central
Keywords
Disciplines
  • Research
License
Unknown

Abstract

Introduction Some people with Parkinson’s disease (PD) frequently have an unsteady gait with shuffling, reduced strength, and increased rigidity. This study has investigated the difference in the neuromuscular strategies of people with early-stage PD, healthy older adults (HOA) and healthy young adult (HYA) during short-distance walking. Method Surface electromyogram (sEMG) was recorded from tibialis anterior (TA) and medial gastrocnemius (MG) muscles along with the acceleration data from the lower leg from 72 subjects—24 people with early-stage PD, 24 HOA and 24 HYA during short-distance walking on a level surface using wearable sensors. Results There was a significant increase in the co-activation, a reduction in the TA modulation and an increase in the TA-MG lateral asymmetry among the people with PD during a level, straight-line walking. For people with PD, the gait impairment scale was low with an average postural instability and gait disturbance (PIGD) score = 5.29 out of a maximum score of 20. Investigating the single and double support phases of the gait revealed that while the muscle activity and co-activation index (CI) of controls modulated over the gait cycle, this was highly diminished for people with PD. The biggest difference between CI of controls and people with PD was during the double support phase of gait. Discussion The study has shown that people with early-stage PD have high asymmetry, reduced modulation, and higher co-activation. They have reduced muscle activity, ability to inhibit antagonist, and modulate their muscle activities. This has the potential for diagnosis and regular assessment of people with PD to detect gait impairments using wearable sensors.

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