Objective: To investigate the contribution of the hip, knee and ankle joint moments to support moments during stair ascent and descent in people with Parkinson’s disease (PD).

Background: Stair walking is one of the most challenging daily life activities accounting for a number of falls in PD patients. During stair walking, larger joint moments are required compared with level-walking for the elevation or lowering of the body’s mass whilst ensuring stability. The support moment is a measure considered to be important for the maintenance of balance and prevention of falls and is calculated as the sum of hip, knee and ankle joint extensor moments (i.e. moments acting against gravity). Research into stair walking identified that the ankle joint moment is the major contributor in healthy older adults. However, due to disease-related declines in strength, PD patients may be unable to produce sufficient lower limb moments to optimise stability. Despite this, research evaluating the support moment during stair walking in PD is limited.

Methods: Twelve PD patients and twelve age-matched controls completed assessments of cognitive function, quality of life, balance confidence and where applicable, symptom severity. Participants performed stair ascent and descent trials with hip, knee and ankle moments calculated using three-dimensional motion analysis and force plates embedded within the staircase. Support moments were calculated as the sum of all extensor moments during the braking phase of stance and the relative joint contributions was calculated.

Results: Linear mixed model analyses that controlled for the PD patients slower walking speed during stair ascent identified that PD and control groups did not differ significantly for support moments during stair ascent or descent. However, analysis of the relative contribution of each joint indicated that the ankle contributed significantly less to the support moment in patients with PD, while the knee contributed significantly more in this population.

Conclusions: During stair walking, PD patients demonstrate a reduced capacity to produce adequately large moments at ankle joint, which appears to be compensated by a greater contribution from the knee joint extension moment. These results may be important for health professionals who are working with this group and may be useful for developing targeted interventions to minimise their risk of falling.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-disease-is-characterised-by-differences-in-lower-limb-joint-kinetics-during-stair-ascent-and-descent/