Objective: To determine factors associated with explicit locomotor learning and saving by people with Parkinson’s disease (PD).

Background: PD leads to movement problems such as impaired motor learning and saving (relearning more quickly when a task is introduced a second time). Reaching studies show people with PD can learn and save an explicit task (one that uses conscious strategy) with some impairment. No explicit learning work in PD has studied walking, but walking is often impaired in PD and rehabilitation depends on instruction and strategy to change movement. This is an analysis of clinical factors potentially associated with explicit locomotor learning and saving by people with PD.

Method: Fifteen people with PD (66.7±7.2 yrs, 11M, all Hoehn & Yahr stage 2) walked on a treadmill (Learning), using visual feedback to take a longer step with one leg (“manipulated”) but leave the other leg’s step unchanged (“non-manipulated”). Participants returned to baseline walking and then performed the new pattern again (Relearning). Error was the difference between the target and each step, normalized by baseline step length. Task learning was the error at end of Learning, while saving was the difference between error at end of Learning and start of Relearning. Participants performed the Timed Up and Go (TUG), TUG with backwards counting, Parkinson’s Disease Cognitive Rating Scale (PD-CRS), and MDS-Unified Parkinson’s Disease Rating Scale Module 3 (MDS-UPDRS3). Regression models analyzed these scores, age, and time since diagnosis as independent variables, with learning and saving as dependent variables.

Results: Participants improved foot placement towards targets in Learning (manipulated leg mean error 8.2±7.0%, non-manipulated 6.6±3.6%), and showed saving of the new pattern (manipulated leg mean saving 3.7±7.4%, non-manipulated 3.9±6.2%). For learning, the factor explaining the most variability in error was MDS-UPDRS3 (R2=0.65, p<0.01 manipulated leg; R2=0.34, p=0.02 non-manipulated leg). For saving, no measurement reached statistical significance as an explanatory variable for error.

Conclusion: People with PD show explicit locomotor learning and saving. The only significant explanatory variable for learning was MDS-UPDRS3 score, while no measurement proved a significant explanatory variable for saving. Locomotor learning but not savings, appears to be related to sensorimotor impairment in individuals with PD.

References: French MA, Morton SM, Charalambous CC, Reisman DS. A locomotor learning paradigm using distorted visual feedback elicits strategic learning. J Neurophysiol. 2018;120(4):1923-1931. Leow LA, Loftus AM, Hammond GR. Impaired savings despite intact initial learning of motor adaptation in Parkinson’s disease. Exp Brain Res. 2012;218(2):295-304. Marinelli L, Quartarone A, Hallett M, Frazzitta G, Felice Ghilardi M. The many facets of motor learning and their relevance for Parkinson’s disease. Clin Neurophysiol. 2017;128(7):1127-1141. Mongeon D, Blanchet P, Messier J. Impact of Parkinson’s disease and dopaminergic medication on adaptation to explicit and implicit visuomotor perturbations. Brain Cogn. 2013;81(2):271-82. Reisman DS, Wityk R, Silver K, Bastian AJ. Improve Walking Symmetry Post-Stroke. Brain. 2010;130(Pt 7):1861-1872. Roemmich RT, Nocera JR, Stegemöller EL, Hassan A, Okun MS, Hass CJ. Locomotor adaptation and locomotor adaptive learning in Parkinson’s disease and normal aging. Clin Neurophysiol. 2014;125(2):313-319.

« Back to MDS Virtual Congress 2020

MDS Abstracts - https://www.mdsabstracts.org/abstract/factors-influencing-explicit-locomotor-learning-and-saving-by-people-with-parkinsons-disease/