Author/Editor     Gregorič, M; Hesse, S; Maležič, M; Mesec, A
Title     Analysis of rigidity, posture and gait in parkinsonism
Translated title     Analiza rigidnosti, drže in hoje pri parkinsonizmu
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 65, št. Suppl 3
Publication year     1996
Volume     str. III-55-62
Language     eng
Abstract     In rigidity the resistance to passively induced movement is position-dependent and not velocity-dependent as is the case in spasticity. Contraray to this classic view, the speed dependence could to some extent be observed also in rigidity. Dorsal flexors of the foot frequently show both reactions: response to shortening and response to strecthing of the muscle. No correlations were detected between rigidity and other signs and symptoms of parkinsonism. The disturbances of posture, balance and gait are characteristic motor abnormalities in parkinsonism: flexed posture, shuffling or festinating gait with small steps, start hesitation, propulsive falling or freezing and poverty of associated movements. The postural reflexes and reactions are inappropriate in parkinsonsm. The impaired antigravity function of the extensor muscles may results in an abnormally flexed body posture. The most significant disturbance of function contributing to the characteristic posture and gait in parkinsonism seems to be the loss of the ability to control the centre of gravity. The movements in lower limb joints during gait are slow and limited. The loading as well as push-off phases are rather weak. The pattern of EMG activity during gait is abnormal in parkinsonism. The dynamic EMG peaks are poorly defined when recorded in the off- phases in patients treated with dopaminergic drugs. A significant change towards a more normal pattern of activity could be observed in the on-phases. Motor control of gait in parkinsonism seem to depend directly on the level of dopaminergic neurotransmitter activity.
Summary     Po klasičnem gledanju je pri rigidnosti upor proti pasivnemu gibu odvisen od položaja, pri spastičnosti pa, nasprotno, od hitrosti. Vendar je upor tudi pri rigidnosti nekoliko odvisen od hitrosti. Pri dorzalnih fleksorjih stopala je pogosto videti obe reakciji: odziv na skrajšanju in odziv na razteg mišice. Korelacija med rigidnostjo in drugimi znaki in simptomi parkinsonizma ni. Motnje drže, ravnotežja in hoje so značilne motorične nenormalnosti pri parkinsonizmu: fleksijska drža, stopicanje ali pospešena hoja z majhnimi koraki, obotavljanje na začetku hoje, propulzivno padanje ali zamrznjenje in siromašnost pridružeih gibov. Posturalni refleksi in reakcije pri parkinsonizmu niso primerni. Moteno protitežnostno delovanje ekstenzorjev lahko povzroči nenormalno fleksijsko držo telesa. Funkcijska motnja, ki je najpomembnejši vzrok značilne drže in hoje pri parkinsonizmu, je verjetno moten nadzor telesnega težišča. Gibi v sklepih spodnjih okončin med hojo so počasni in omejeni. Sile pri dostopu kakor tudi odrivu telesa so šibkejše. Elektromiografska aktivnost med hojo ima pri parkinsonizmu nenormalen vzorec. V fazah izklopljenosti ("off") so pri bolnikih, ki jemljejo dopaminergična zdravila, vrhovi EMG-ja le slabo opredeljeni. V fazah vklopljenosti ("on") lahko opazujemo statistično pomemben pomik k normalnejšemu vzorcu aktivnosti. Zdi se, da je motorični nadzor hoje pri parkinsonizmu neposredno odvisen od ravni dopaminergične nevrotransmitorske aktivnosti.
Descriptors     PARKINSON DISEASE
MUSCLE RIGIDITY
POSTURE
GAIT