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Los Angeles E, de Oliveira CEN, Cupertino L, Shokur S, Bouri M, Coelho DB. Effect of disease, freezing of gait, and dopaminergic medication in the biomechanics of trunk and upper limbs in the gait of Parkinson's disease. Hum Mov Sci 2024; 96:103242. [PMID: 38850765 DOI: 10.1016/j.humov.2024.103242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/17/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
INTRODUCTION Parkinson's disease (PD) causes gait abnormalities that may be associated with an arm swing reduction. Medication and freezing of gait (FoG) may influence gait characteristics. However, these comparisons do not consider differences in gait speed and clinical characteristics in individuals with PD. OBJECTIVE This study aims to analyze the effect of FoG and medication on the biomechanics of the trunk and upper limbs during gait in PD, controlling for gait speed and clinical differences between groups. METHODS Twenty-two people with a clinical diagnosis of idiopathic PD in ON and OFF medication (11 FoG), and 35 healthy participants (control) were selected from two open data sets. All participants walked on the floor on a 10-m-long walkway. The joint and linear kinematic variables of gait were compared: (1) Freezers and nonfreezers in the ON condition and control; (2) Freezers and nonfreezers in the OFF condition and control; (3) Group (freezers and nonfreezers) and medication. RESULTS The disease affects the upper limbs more strongly but not the trunk. The medication does not significantly influence the joint characteristics but rather the linear wrist displacement. The FoG does not affect trunk movement and partially influences the upper limbs. The interaction between medications and FoG suggests that the medication causes more substantial improvement in freezers than in nonfreezers. CONCLUSION The study shows differences in the biomechanics of the upper limbs of people with PD, FoG, and the absence of medication. The future rehabilitation protocol should consider this aspect.
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Affiliation(s)
- Emanuele Los Angeles
- Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
| | | | - Layla Cupertino
- Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Solaiman Shokur
- École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Mohamed Bouri
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Daniel Boari Coelho
- Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil.; Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, SP, Brazil..
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Barbieri RA, Kalva-Filho CA, Faria MH, Silveira-Ciola AP, Torriani-Pasin C, Simieli L, Barbieri FA. Parkinson's Critical Heart Rate Test: Applying the Critical Power Model for People with Parkinson's Disease. J Hum Kinet 2024; 93:81-92. [PMID: 39132420 PMCID: PMC11307192 DOI: 10.5114/jhk/186562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 03/27/2024] [Indexed: 08/13/2024] Open
Abstract
Aerobic exercise with the correct intensity can attenuate motor and non-motor symptoms of Parkinson's disease (PD) and improve the quality of life. However, a specific, validated, non-invasive, and outside the laboratory protocol that assesses physiological variables to prescribe optimal aerobic exercise intensity for people with PD is nonexistent. Therefore, this study aimed to propose a protocol, the Parkinson's critical heart rate test (Parkinson-CHR test), to determine the critical heart rate (CHR) in individuals with PD and verify its validity, reliability, and sensitivity. Fifteen people with idiopathic PD, who were able to practice exercises, were recruited to participate in the study (71.1 ± 6.6 years). The study consisted of two experiments: i) the first one aimed to assess the validity and reliability of the protocol, with participants performing the test twice at a one-week interval; ii) the second experiment aimed to investigate the protocol sensitivity, with individuals being evaluated before and after an 8-week training program according to Parkinson-CHR intensity. In experiment 1, no differences between test and retest were observed in the time to cover the distances (400, 800 and 1200 m), the total heart rate, the critical heart rate, and critical speed (p > 0.05). In experiment 2, there was a reduction in time to cover 400 and 800 m as well as in the total heart rate for all distances after the 8-week training program. The Parkinson-CHR test is a reliable, reproducible, inexpensive, and non-invasive protocol to assess, prescribe, and monitor aerobic exercise intensity in people with PD.
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Affiliation(s)
| | - Carlos Augusto Kalva-Filho
- School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), São Paulo State University (Unesp), Bauru, SP, Brazil
| | - Murilo Henrique Faria
- School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), São Paulo State University (Unesp), Bauru, SP, Brazil
| | - Aline Prieto Silveira-Ciola
- School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), São Paulo State University (Unesp), Bauru, SP, Brazil
| | - Camila Torriani-Pasin
- Department of Physical Therapy and Movement Sciences, University of Texas, El Paso, USA
| | - Lucas Simieli
- School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), São Paulo State University (Unesp), Bauru, SP, Brazil
| | - Fabio Augusto Barbieri
- School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), São Paulo State University (Unesp), Bauru, SP, Brazil
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Bath JE, Wang DD. Unraveling the threads of stability: A review of the neurophysiology of postural control in Parkinson's disease. Neurotherapeutics 2024; 21:e00354. [PMID: 38579454 PMCID: PMC11000188 DOI: 10.1016/j.neurot.2024.e00354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 04/07/2024] Open
Abstract
Postural instability is a detrimental and often treatment-refractory symptom of Parkinson's disease. While many existing studies quantify the biomechanical deficits among various postural domains (static, anticipatory, and reactive) in this population, less is known regarding the neural network dysfunctions underlying these phenomena. This review will summarize current studies on the cortical and subcortical neural activities during postural responses in healthy subjects and those with Parkinson's disease. We will also review the effects of current therapies, including neuromodulation and feedback-based wearable devices, on postural instability symptoms. With recent advances in implantable devices that allow chronic, ambulatory neural data collection from patients with Parkinson's disease, combined with sensors that can quantify biomechanical measurements of postural responses, future work using these devices will enable better understanding of the neural mechanisms of postural control. Bridging this knowledge gap will be the critical first step towards developing novel neuromodulatory interventions to enhance the treatment of postural instability in Parkinson's disease.
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Affiliation(s)
- Jessica E Bath
- Department of Physical Therapy & Rehabilitation Science, University of California, San Francisco, USA; Department of Neurological Surgery, University of California, San Francisco, USA
| | - Doris D Wang
- Department of Neurological Surgery, University of California, San Francisco, USA.
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Penedo T, Kalva-Filho CA, Cursiol JA, Faria MH, Coelho DB, Barbieri FA. Spatial-temporal parameters during unobstructed walking in people with Parkinson's disease and healthy older people: a public data set. Front Aging Neurosci 2024; 16:1354738. [PMID: 38605861 PMCID: PMC11007149 DOI: 10.3389/fnagi.2024.1354738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/15/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
- Tiago Penedo
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, São Paulo State University (Unesp), Bauru, Brazil
| | - Carlos Augusto Kalva-Filho
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, São Paulo State University (Unesp), Bauru, Brazil
| | - Jônatas Augusto Cursiol
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, São Paulo State University (Unesp), Bauru, Brazil
| | - Murilo Henrique Faria
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, São Paulo State University (Unesp), Bauru, Brazil
| | - Daniel Boari Coelho
- Center for Mathematics, Computation, and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
- Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Fabio Augusto Barbieri
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, São Paulo State University (Unesp), Bauru, Brazil
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Coelho DB, Mochizuki L, Moreno VC, Santinelli FB, Beretta VS, Barbieri FA. Postural control of prolonged standing in people with Parkinson's disease. Hum Mov Sci 2024; 93:103177. [PMID: 38159455 DOI: 10.1016/j.humov.2023.103177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 12/11/2023] [Accepted: 12/23/2023] [Indexed: 01/03/2024]
Abstract
People with Parkinson's disease (pwPD) have reduced adaptability to postural control during prolonged standing compared to neurologically healthy individuals (control). Objective. The study aimed to characterize postural changes during prolonged standing and their effect on postural control in pwPD compared to control. We recorded the body sway of the second lumbar vertebra of 23 pwPD and 23 control while they performed prolonged standing (15 min). The number and amplitude of the body sway patterns (shifts, fidgets, and drifts), the root mean square, velocity, and frequency of the body sway were analyzed. The number of shifts in the anterior-posterior (AP) and medial-lateral (ML) directions was greater for the pwPD than the control. In addition, the amplitudes of shifts in the AP direction and fidgets in the AP and ML directions were greater for the pwPD than the control. Our results show that: (1) A larger number of shifts of body sway suggest references positions are frequently changing; (2) Fidgets is a pumping mechanism and can be sensory-demand action to restore mechanoreceptors activity on the foot sole; and (3) No drift changes may suggest there is no slow migration of reference position. We conclude that pwPD exhibits different behavior than healthy ones during prolonged standing, suggesting that prolonged standing could distinguish individuals with Parkinson's disease.
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Affiliation(s)
- Daniel Boari Coelho
- Center for Mathematics, Computation, and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil; Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, SP, Brazil
| | - Luis Mochizuki
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, SP, Brazil
| | - Vinicius Christianini Moreno
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, Faculty of Sciences, São Paulo State University (Unesp), Bauru, SP, Brazil
| | - Felipe Balistieri Santinelli
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, Faculty of Sciences, São Paulo State University (Unesp), Bauru, SP, Brazil; REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Victor Spiandor Beretta
- São Paulo State University (Unesp), School of Technology and Sciences, Physical Education Department, Presidente Prudente, São Paulo, Brazil
| | - Fabio Augusto Barbieri
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, Faculty of Sciences, São Paulo State University (Unesp), Bauru, SP, Brazil.
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Packer E, Debelle H, Bailey HGB, Ciravegna F, Ireson N, Evers J, Niessen M, Shi JQ, Yarnall AJ, Rochester L, Alcock L, Del Din S. Translating digital healthcare to enhance clinical management: a protocol for an observational study using a digital health technology system to monitor medication adherence and its effect on mobility in people with Parkinson's. BMJ Open 2023; 13:e073388. [PMID: 37666560 PMCID: PMC10481731 DOI: 10.1136/bmjopen-2023-073388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/18/2023] [Indexed: 09/06/2023] Open
Abstract
INTRODUCTION In people with Parkinson's (PwP) impaired mobility is associated with an increased falls risk. To improve mobility, dopaminergic medication is typically prescribed, but complex medication regimens result in suboptimal adherence. Exploring medication adherence and its impact on mobility in PwP will provide essential insights to optimise medication regimens and improve mobility. However, this is typically assessed in controlled environments, during one-off clinical assessments. Digital health technology (DHT) presents a means to overcome this, by continuously and remotely monitoring mobility and medication adherence. This study aims to use a novel DHT system (DHTS) (comprising of a smartphone, smartwatch and inertial measurement unit (IMU)) to assess self-reported medication adherence, and its impact on digital mobility outcomes (DMOs) in PwP. METHODS AND ANALYSIS This single-centre, UK-based study, will recruit 55 participants with Parkinson's. Participants will complete a range of clinical, and physical assessments. Participants will interact with a DHTS over 7 days, to assess self-reported medication adherence, and monitor mobility and contextual factors in the real world. Participants will complete a motor complications diary (ON-OFF-Dyskinesia) throughout the monitoring period and, at the end, a questionnaire and series of open-text questions to evaluate DHTS usability. Feasibility of the DHTS and the motor complications diary will be assessed. Validated algorithms will quantify DMOs from IMU walking activity. Time series modelling and deep learning techniques will model and predict DMO response to medication and effects of contextual factors. This study will provide essential insights into medication adherence and its effect on real-world mobility in PwP, providing insights to optimise medication regimens. ETHICS AND DISSEMINATION Ethical approval was granted by London-142 Westminster Research Ethics Committee (REC: 21/PR/0469), protocol V.2.4. Results will be published in peer-reviewed journals. All participants will provide written, informed consent. TRIAL REGISTRATION NUMBER ISRCTN13156149.
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Affiliation(s)
- Emma Packer
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Héloïse Debelle
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Harry G B Bailey
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Fabio Ciravegna
- Dipartimento di Informatica, Università di Torino, Torino, Italy
| | - Neil Ireson
- Department of Computer Science and INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK
| | | | | | - Jian Qing Shi
- Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen, Guangdong, China
- National Center for Applied Mathematics, Shenzhen, Guangdong, China
| | - Alison J Yarnall
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Lynn Rochester
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Lisa Alcock
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Based at The Newcastle upon Tyne Hospitals NHS Foundation Trust, NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Silvia Del Din
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Based at The Newcastle upon Tyne Hospitals NHS Foundation Trust, NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK
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Roytman S, Paalanen R, Griggs A, David S, Pongmala C, Koeppe RA, Scott PJH, Marusic U, Kanel P, Bohnen NI. Cholinergic system correlates of postural control changes in Parkinson's disease freezers. Brain 2023; 146:3243-3257. [PMID: 37086478 PMCID: PMC10393403 DOI: 10.1093/brain/awad134] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/16/2023] [Accepted: 04/06/2023] [Indexed: 04/24/2023] Open
Abstract
Postural instability and freezing of gait are the most debilitating dopamine-refractory motor impairments in advanced stages of Parkinson's disease because of increased risk of falls and poorer quality of life. Recent findings suggest an inability to efficaciously utilize vestibular information during static posturography among people with Parkinson's disease who exhibit freezing of gait, with associated changes in cholinergic system integrity as assessed by vesicular acetylcholine transporter PET. There is a lack of adequate understanding of how postural control varies as a function of available sensory information in patients with Parkinson's disease with freezing of gait. The goal of this cross-sectional study was to examine cerebral cholinergic system changes that associate with inter-sensory postural control processing features as assessed by dynamic computerized posturography and acetylcholinesterase PET. Seventy-five participants with Parkinson's disease, 16 of whom exhibited freezing of gait, underwent computerized posturography on the NeuroCom© Equitest sensory organization test platform, striatal dopamine, and acetylcholinesterase PET scanning. Findings demonstrated that patients with Parkinson's disease with freezing of gait have greater difficulty maintaining balance in the absence of reliable proprioceptive cues as compared to those without freezing of gait [β = 0.28 (0.021, 0.54), P = 0.034], an effect that was independent of disease severity [β = 0.16 (0.062, 0.26), P < 0.01] and age [β = 0.092 (-0.005, 0.19), P = 0.062]. Exploratory voxel-based analysis revealed an association between postural control and right hemispheric cholinergic network related to visual-vestibular integration and self-motion perception. High anti-cholinergic burden predicted postural control impairment in a manner dependent on right hemispheric cortical cholinergic integrity [β = 0.34 (0.065, 0.61), P < 0.01]. Our findings advance the perspective that cortical cholinergic system might play a role in supporting postural control after nigro-striatal dopaminergic losses in Parkinson's disease. Failure of cortex-dependent visual-vestibular integration may impair detection of postural instability in absence of reliable proprioceptive cues. Better understanding of how the cholinergic system plays a role in this process may augur novel treatments and therapeutic interventions to ameliorate debilitating symptoms in patients with advanced Parkinson's disease.
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Affiliation(s)
- Stiven Roytman
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Rebecca Paalanen
- Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alexis Griggs
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
- Parkinson’s Foundation Research Center of Excellence, University of Michigan, Ann Arbor, MI 48109, USA
| | - Simon David
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Chatkaew Pongmala
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
- Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI 48109, USA
| | - Robert A Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
- Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI 48109, USA
| | - Peter J H Scott
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Uros Marusic
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
- Institute for Kinesiology Research, Science and Research Centre Koper, 6000 Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea—ECM, 2000 Maribor, Slovenia
| | - Prabesh Kanel
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
- Parkinson’s Foundation Research Center of Excellence, University of Michigan, Ann Arbor, MI 48109, USA
- Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI 48109, USA
| | - Nicolaas I Bohnen
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA
- Parkinson’s Foundation Research Center of Excellence, University of Michigan, Ann Arbor, MI 48109, USA
- Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI 48109, USA
- Neurology Service and GRECC, VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA
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Shida TKF, Costa TM, de Oliveira CEN, de Castro Treza R, Hondo SM, Los Angeles E, Bernardo C, Dos Santos de Oliveira L, de Jesus Carvalho M, Coelho DB. A public data set of walking full-body kinematics and kinetics in individuals with Parkinson's disease. Front Neurosci 2023; 17:992585. [PMID: 36875659 PMCID: PMC9978741 DOI: 10.3389/fnins.2023.992585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
Background To our knowledge, there is no Parkinson's disease (PD) gait biomechanics data sets available to the public. Objective This study aimed to create a public data set of 26 idiopathic individuals with PD who walked overground on ON and OFF medication. Materials and methods Their upper extremity, trunk, lower extremity, and pelvis kinematics were measured using a three-dimensional motion-capture system (Raptor-4; Motion Analysis). The external forces were collected using force plates. The results include raw and processed kinematic and kinetic data in c3d and ASCII files in different file formats. In addition, a metadata file containing demographic, anthropometric, and clinical data is provided. The following clinical scales were employed: Unified Parkinson's disease rating scale motor aspects of experiences of daily living and motor score, Hoehn & Yahr, New Freezing of Gait Questionnaire, Montreal Cognitive Assessment, Mini Balance Evaluation Systems Tests, Fall Efficacy Scale-International-FES-I, Stroop test, and Trail Making Test A and B. Results All data are available at Figshare (https://figshare.com/articles/dataset/A_dataset_of_overground_walking_full-body_kinematics_and_kinetics_in_individuals_with_Parkinson_s_disease/14896881). Conclusion This is the first public data set containing a three-dimensional full-body gait analysis of individuals with PD under the ON and OFF medication. It is expected to contribute so that different research groups worldwide have access to reference data and a better understanding of the effects of medication on gait.
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Affiliation(s)
| | - Thaisy Moraes Costa
- Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Claudia Eunice Neves de Oliveira
- Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, Brazil.,Center for Mathematics, Computation, and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Renata de Castro Treza
- Center for Mathematics, Computation, and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Sandy Mikie Hondo
- Center for Mathematics, Computation, and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Emanuele Los Angeles
- Center for Mathematics, Computation, and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Claudionor Bernardo
- Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, Brazil
| | | | | | - Daniel Boari Coelho
- Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, Brazil.,Center for Mathematics, Computation, and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
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