Temporal dynamics of gait asymmetry in people with Parkinson's Disease after ingestion of the first dose of levodopa

Abstract

Gait asymmetry in people with Parkinson's disease (PD) is a factor that can differentiate PD from other neurodegenerative diseases and has been linked to a greater chance of falling during gait, as asymmetry can lead to worse control and coordination of movements to the most affected limb by the disease. Although the pharmacological treatment seems to alleviate the asymmetry between limbs and gait variability, the effects of the temporal dynamics of the dopaminergic medication for people with PD remain uncertain, especially in relation to the limb most affected by the disease. Thus, the aim of this study is to investigate the behavior of temporal dynamics in gait asymmetry after ingesting the first-morning dose of dopaminergic medication in spatiotemporal gait parameters, muscle, and cortical activity in people with PD. For this purpose, 15 people with PD will perform unobstructed gait in the "OFF" state of the dopaminergic medication and every 30 minutes up to 3 hours after ingesting the first dose of levodopa (ON 180'). In the attempt, each participant will be instructed to walk, at their preferred velocity, in a walkway (8.5 m long x 3.5 m wide). Therefore, the participants will make a total of five attempts of gait in each moment (every 30 minutes). The symmetry index of the parameters of interest (spatial-temporal, EMG, and EEG) will be compared by ANOVAs between periods (OFF, ON 0' to 180'). In addition, Tukey's Post hoc tests will be used when the significant effect is presented. The ANOVA assumptions will be tested using the sphericity test (Mauchly) and the variance equality test (Levene) for the symmetry index of all the variables used in the study.(AU)