Effects of bilateral subthalamic stimulation on gait kinematics and kinetics in Parkinson's disease

Exp Brain Res. 2005 Jan;160(4):517-27. doi: 10.1007/s00221-004-2036-5. Epub 2004 Oct 22.

Abstract

Subthalamic nucleus (STN) stimulation, a recent surgical approach to Parkinson's disease (PD), has been shown to be effective in relieving motor symptoms. The present study carried out a full body gait analysis, during overground walking, on ten PD patients with bilaterally implanted STN stimulation devices. Walking performance was analyzed on the same day, in four conditions (Stim Off-Med Off, Stim On-Med Off, Stim Off-Med On, Stim On-Med On). The results showed that, on average, STN stimulation alone (S+M-) and L-dopa alone (S-M+), significantly increased gait speed, stride length and the lower limb joint Range of Motion (ROM) with respect to the basal condition (S-M-); also cadence was found to play a role in velocity increase, particularly when L-dopa was administered. Both treatments improved pelvis and trunk kinematics, and power production at the ankle and hip joints. The combination of the two treatments (S+M+) produced an additional effect on gait speed, stride length, ROM of knee and ankle joints, pelvis obliquity and trunk inclination. Given the additive and synergistic effects, it can be hypothesized that the two treatments have different mechanisms of action. Our results confirm the findings of earlier studies that employed treadmill walking.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antiparkinson Agents / pharmacology
  • Biomechanical Phenomena
  • Deep Brain Stimulation / methods*
  • Electrodes, Implanted
  • Female
  • Functional Laterality / physiology
  • Gait / physiology*
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / physiopathology
  • Gait Disorders, Neurologic / therapy*
  • Humans
  • Leg / physiology
  • Leg / physiopathology
  • Levodopa / pharmacology
  • Male
  • Middle Aged
  • Parkinson Disease / physiopathology
  • Parkinson Disease / therapy*
  • Range of Motion, Articular / drug effects
  • Range of Motion, Articular / physiology
  • Recovery of Function / drug effects
  • Recovery of Function / physiology
  • Subthalamic Nucleus / physiopathology*
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • Levodopa