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Gait Posture. 2017 Sep;57:252-257. doi: 10.1016/j.gaitpost.2017.06.267. Epub 2017 Jun 27.

Trunk-lower limb coordination pattern during gait in patients with ataxia.

Author information

1
Complex Operative Unit of Neurology, Fondazione Policlinico Universitario Agostino Gemelli, L.go F. Vito, 1-00168 Rome, Italy. Electronic address: pietro.caliandro@policlinicogemelli.it.
2
Fondazione Don Carlo Gnocchi, P.le R. Morandi, 6-20121 Milan, Italy.
3
Institute of Neurology, Dept. Geriatrics, Neuroscience & Orthopaedics, Catholic University, L.go F. Vito, 1-00168 Rome, Italy; IRCSS S. Raffaele Pisana, Via della Pisana, 235-00163 Rome, Italy.
4
Fondazione Don Carlo Gnocchi, P.le R. Morandi, 6-20121 Milan, Italy; Institute of Neurology, Dept. Geriatrics, Neuroscience & Orthopaedics, Catholic University, L.go F. Vito, 1-00168 Rome, Italy.
5
Department of Medical and Surgical Sciences and Biotechnologies, University of Rome Polo Pontino, Corso della Repubblica, 79-04010 Latina, Italy.
6
Institute of Neurology, Dept. Geriatrics, Neuroscience & Orthopaedics, Catholic University, L.go F. Vito, 1-00168 Rome, Italy.

Abstract

OBJECTIVE:

Although deficit of coordination between the upper and lower body segments might play an important role in impairing gait and stability in ataxic patients, this deficit has not been investigated in subjects with ataxia so far. To evaluate the coordination between trunk and thigh in a sample of patients with ataxia compared with healthy controls and to correlate the coordination measures with the clinical severity.

DESIGN:

Prospective observational study.

SUBJECTS:

Sixteen patients with degenerative cerebellar ataxia and sixteen age- and sex-matched controls were studied.

METHODS:

We assessed the coordination on the sagittal plane between trunk and thigh, considered as rigid segments, by the continuous relative phase (CRP) method. We used the coefficient of multiple correlation (CMC) to measure the within-subject (CMCWS) variability, and the SARA scale to assess clinical severity.

RESULTS:

CRP curves are dissimilar between ataxic patients and controls, the former showing a chaotic behavior compared to the well-shaped CRP curves observed in the latter. Trunk-thigh coordination has a higher within-subject variability in ataxic patients (median CMCWS: 0.53 for patients, 0.89 for controls, p<0.001). We also found that the CMCWS of the CRP curves negatively correlates with the gait (ρ: -0.565, p: 0.023) and stance (ρ: -0.567, p: 0.022) sub-scores and the total score of the SARA scale (ρ: -0.711, p: 0.002).

CONCLUSIONS:

Ataxia shows a deficit of spatio-temporal coordination between trunk and thigh. Such a deficit is correlated with the degree of the clinical impairment indicating an important role of inter-segmental coordination in determining the severity of ataxia.

KEYWORDS:

Ataxia; Cerebellum; Coordination; Gait

PMID:
28683416
DOI:
10.1016/j.gaitpost.2017.06.267
[Indexed for MEDLINE]

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