Strength of hip muscles and bradykinesia contribute to walking speed over a long distance, but not a short distance, in people with mild Parkinson’s disease: An observational study

Bradykinesia and postural instability contribute to walking limitations in people with Parkinson’s disease (PD), but the contribution of muscle strength to walking speed has not been examined extensively. Does strength of the major lower limb muscles contribute to walking speed over short and long d...

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Published inGait & posture Vol. 100; pp. 103 - 106
Main Authors Preston, E., Salmon, R., de Meillon, N., Boom, M., Ada, L., Mahendran, N., Flynn, A.
Format Journal Article
LanguageEnglish
Published England Elsevier B.V 01.02.2023
Subjects
Online AccessGet full text
ISSN0966-6362
1879-2219
1879-2219
DOI10.1016/j.gaitpost.2022.11.061

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Abstract Bradykinesia and postural instability contribute to walking limitations in people with Parkinson’s disease (PD), but the contribution of muscle strength to walking speed has not been examined extensively. Does strength of the major lower limb muscles contribute to walking speed over short and long distances in people with PD? na. A cross-sectional, observational study. 50 people with mild PD. Maximum isometric strength of the flexors and extensors of the lower limb was measured using hand-held dynamometry. Flexed posture, postural instability and bradykinesia were measured using the MDS-UPDRS part III. Walking speed was measured during the 10-m Walk Test and 6-min Walk Test. Univariate analysis revealed that age, bradykinesia, flexed posture, and hip, knee and ankle weakness were all significantly correlated with walking speed over short and long distances. Multiple regression analysis revealed that age, bradykinesia, flexed posture and weakness of the hip and knee muscles together accounted for 47% of the variance in walking speed over a short distance, with age (R2 = 0.11, p = 0.003) making a significant independent contribution. Age, bradykinesia, flexed posture and strength of the hip and knee muscles together accounted for 56% of the variance in walking speed over a long distance. Age (R2 = 0.12, p = 0.001), weakness of the hip muscles (R2 = 0.12, p = 0.001) and bradykinesia (R2 = 0.04, p = 0.04) made significant, independent contributions to the variance in walking speed over a long distance. In people with mild PD, weakness of the hip muscles and bradykinesia only make a significant relative contribution to walking speed over a long distance. Therefore, in people with normal walking speed over a short distance the 6-min Walk Test could be measured to more effectively identify the impact of motor impairments on walking. •PwP with normal walking speed over 10 m are relatively slower over a longer distance.•Hip strength and bradykinesia contribute to long, but not short distance walk speed.•To assess the impact of motor impairments on walking the 6MWT should be used in PwP.
AbstractList Bradykinesia and postural instability contribute to walking limitations in people with Parkinson’s disease (PD), but the contribution of muscle strength to walking speed has not been examined extensively. Does strength of the major lower limb muscles contribute to walking speed over short and long distances in people with PD? na. A cross-sectional, observational study. 50 people with mild PD. Maximum isometric strength of the flexors and extensors of the lower limb was measured using hand-held dynamometry. Flexed posture, postural instability and bradykinesia were measured using the MDS-UPDRS part III. Walking speed was measured during the 10-m Walk Test and 6-min Walk Test. Univariate analysis revealed that age, bradykinesia, flexed posture, and hip, knee and ankle weakness were all significantly correlated with walking speed over short and long distances. Multiple regression analysis revealed that age, bradykinesia, flexed posture and weakness of the hip and knee muscles together accounted for 47% of the variance in walking speed over a short distance, with age (R2 = 0.11, p = 0.003) making a significant independent contribution. Age, bradykinesia, flexed posture and strength of the hip and knee muscles together accounted for 56% of the variance in walking speed over a long distance. Age (R2 = 0.12, p = 0.001), weakness of the hip muscles (R2 = 0.12, p = 0.001) and bradykinesia (R2 = 0.04, p = 0.04) made significant, independent contributions to the variance in walking speed over a long distance. In people with mild PD, weakness of the hip muscles and bradykinesia only make a significant relative contribution to walking speed over a long distance. Therefore, in people with normal walking speed over a short distance the 6-min Walk Test could be measured to more effectively identify the impact of motor impairments on walking. •PwP with normal walking speed over 10 m are relatively slower over a longer distance.•Hip strength and bradykinesia contribute to long, but not short distance walk speed.•To assess the impact of motor impairments on walking the 6MWT should be used in PwP.
Bradykinesia and postural instability contribute to walking limitations in people with Parkinson's disease (PD), but the contribution of muscle strength to walking speed has not been examined extensively.BACKGROUNDBradykinesia and postural instability contribute to walking limitations in people with Parkinson's disease (PD), but the contribution of muscle strength to walking speed has not been examined extensively.Does strength of the major lower limb muscles contribute to walking speed over short and long distances in people with PD?RESEARCH QUESTIONDoes strength of the major lower limb muscles contribute to walking speed over short and long distances in people with PD?na.METHODna.A cross-sectional, observational study.DESIGNA cross-sectional, observational study.50 people with mild PD.PARTICIPANTS50 people with mild PD.Maximum isometric strength of the flexors and extensors of the lower limb was measured using hand-held dynamometry. Flexed posture, postural instability and bradykinesia were measured using the MDS-UPDRS part III. Walking speed was measured during the 10-m Walk Test and 6-min Walk Test.OUTCOME MEASURESMaximum isometric strength of the flexors and extensors of the lower limb was measured using hand-held dynamometry. Flexed posture, postural instability and bradykinesia were measured using the MDS-UPDRS part III. Walking speed was measured during the 10-m Walk Test and 6-min Walk Test.Univariate analysis revealed that age, bradykinesia, flexed posture, and hip, knee and ankle weakness were all significantly correlated with walking speed over short and long distances. Multiple regression analysis revealed that age, bradykinesia, flexed posture and weakness of the hip and knee muscles together accounted for 47% of the variance in walking speed over a short distance, with age (R2 = 0.11, p = 0.003) making a significant independent contribution. Age, bradykinesia, flexed posture and strength of the hip and knee muscles together accounted for 56% of the variance in walking speed over a long distance. Age (R2 = 0.12, p = 0.001), weakness of the hip muscles (R2 = 0.12, p = 0.001) and bradykinesia (R2 = 0.04, p = 0.04) made significant, independent contributions to the variance in walking speed over a long distance.RESULTSUnivariate analysis revealed that age, bradykinesia, flexed posture, and hip, knee and ankle weakness were all significantly correlated with walking speed over short and long distances. Multiple regression analysis revealed that age, bradykinesia, flexed posture and weakness of the hip and knee muscles together accounted for 47% of the variance in walking speed over a short distance, with age (R2 = 0.11, p = 0.003) making a significant independent contribution. Age, bradykinesia, flexed posture and strength of the hip and knee muscles together accounted for 56% of the variance in walking speed over a long distance. Age (R2 = 0.12, p = 0.001), weakness of the hip muscles (R2 = 0.12, p = 0.001) and bradykinesia (R2 = 0.04, p = 0.04) made significant, independent contributions to the variance in walking speed over a long distance.In people with mild PD, weakness of the hip muscles and bradykinesia only make a significant relative contribution to walking speed over a long distance. Therefore, in people with normal walking speed over a short distance the 6-min Walk Test could be measured to more effectively identify the impact of motor impairments on walking.SIGNIFICANCEIn people with mild PD, weakness of the hip muscles and bradykinesia only make a significant relative contribution to walking speed over a long distance. Therefore, in people with normal walking speed over a short distance the 6-min Walk Test could be measured to more effectively identify the impact of motor impairments on walking.
Bradykinesia and postural instability contribute to walking limitations in people with Parkinson's disease (PD), but the contribution of muscle strength to walking speed has not been examined extensively. Does strength of the major lower limb muscles contribute to walking speed over short and long distances in people with PD? na. A cross-sectional, observational study. 50 people with mild PD. Maximum isometric strength of the flexors and extensors of the lower limb was measured using hand-held dynamometry. Flexed posture, postural instability and bradykinesia were measured using the MDS-UPDRS part III. Walking speed was measured during the 10-m Walk Test and 6-min Walk Test. Univariate analysis revealed that age, bradykinesia, flexed posture, and hip, knee and ankle weakness were all significantly correlated with walking speed over short and long distances. Multiple regression analysis revealed that age, bradykinesia, flexed posture and weakness of the hip and knee muscles together accounted for 47% of the variance in walking speed over a short distance, with age (R = 0.11, p = 0.003) making a significant independent contribution. Age, bradykinesia, flexed posture and strength of the hip and knee muscles together accounted for 56% of the variance in walking speed over a long distance. Age (R = 0.12, p = 0.001), weakness of the hip muscles (R = 0.12, p = 0.001) and bradykinesia (R = 0.04, p = 0.04) made significant, independent contributions to the variance in walking speed over a long distance. In people with mild PD, weakness of the hip muscles and bradykinesia only make a significant relative contribution to walking speed over a long distance. Therefore, in people with normal walking speed over a short distance the 6-min Walk Test could be measured to more effectively identify the impact of motor impairments on walking.
Author Ada, L.
Preston, E.
Flynn, A.
Mahendran, N.
Salmon, R.
de Meillon, N.
Boom, M.
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Keywords Parkinson disease
Walking
Muscle weakness
Regression analysis
Hypokinesia
Language English
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Snippet Bradykinesia and postural instability contribute to walking limitations in people with Parkinson’s disease (PD), but the contribution of muscle strength to...
Bradykinesia and postural instability contribute to walking limitations in people with Parkinson's disease (PD), but the contribution of muscle strength to...
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SubjectTerms Cross-Sectional Studies
Humans
Hypokinesia
Muscle Strength - physiology
Muscle weakness
Muscle, Skeletal - physiology
Parkinson Disease
Regression analysis
Walking
Walking - physiology
Walking Speed
Title Strength of hip muscles and bradykinesia contribute to walking speed over a long distance, but not a short distance, in people with mild Parkinson’s disease: An observational study
URI https://www.clinicalkey.com/#!/content/1-s2.0-S0966636222006981
https://dx.doi.org/10.1016/j.gaitpost.2022.11.061
https://www.ncbi.nlm.nih.gov/pubmed/36508883
https://www.proquest.com/docview/2754047861
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