TY  - JOUR
PY  - 2018//
TI  - Medication status and dual-tasking on turning strategies in Parkinson disease
JO  - Journal of the neurological sciences
A1  - Adamson, M. B.
A1  - Gilmore, G.
A1  - Stratton, T. W.
A1  - Baktash, N.
A1  - Jog, M. S.
SP  - 206
EP  - 212
VL  - 396
IS  - 
N2  - BACKGROUND: Parkinson disease (PD) patients have turning impairments that may increase fall risk. Clinics lack specialized kinematic equipment used in gait and turn analysis and require a simple method to evaluate fall risk and advise patients in turning strategy selection. <br><br>OBJECTIVES: To enhance understanding of PD turning strategies and determine if turning can be assessed using a video-recording and categorization method, we compared 180-degree and 90-degree turns as a function of medication status and dual-tasking (DT). <br><br>METHODS: 21 PD participants (H&Y stage 1-3) in PD-ON and PD-OFF medication states and 16 controls completed 180-degree and 90-degree turn-tasks with and without DT. Video-recordings of tasks permitted classification of 180-degree turns into Few-Step turns (FST) vs. Multi-Step turns (MST) and 90-degree turns into Step vs. Spin-turns. FST were further sub-classified into Twisting vs. Sideways turns and MST into Backward, Festination, Forward or Wheeling turns. Percentages of subtypes were analyzed across groups by task. <br><br>RESULTS: IN 180-degree tasks, there was an effect of group: FST vs. MST F(2,55) = 9.578, p < .001. PD participants in the off-medication state (PD-OFF) produced significantly more MST with a larger number of different turning subtypes vs. controls or PD on medication (PD-ON). In 90-degree tasks, controls significantly increased their proportion of Step-turns while DT (p < .001), an adaptation not observed in PD-ON or PD-OFF. <br><br>CONCLUSIONS: PD turning impairments may stem from an inability to select a unified turning strategy and to adapt to the turning environment, which may be exacerbated in PD-OFF. Video-analysis may prove beneficial in predicting a clinical course for PD patients by revealing features of turning dysfunction.<br><br>Copyright © 2018 Elsevier B.V. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0022-510X
UR  - http://dx.doi.org/10.1016/j.jns.2018.11.028
ID  - ref1
ER  -