Abstract | INTRODUCTION: METHOD: The patient was assessed with the Unified Dystonia Rating Scale, underwent motion analysis with an optoelectronic system and postural analysis with force plates. RESULTS: This study provides a detailed quantification of gait parameters in a Dopa-Responsive Dystonia patient. Prior to treatment, mean walking speed was severely reduced, gait cadence and step length were decreased and stride width was increased. Right lower limb and pelvis showed kinematic defects, trunk and Centre of Mass were backwards. During levodopa therapy, the walking speed was doubled, gait cadence and step length were increased and stride width was reduced. Nearly all kinematic parameters of lower limbs were significantly improved. The patient's Centre of Mass during gait and Centre of pressure in static position both shifted forward. CONCLUSION:
Levodopa dramatically decreased dystonia and improved spatio-temporal, kinematic and posture parameters. Our main pathophysiological hypothesis is that trunk tilt and its consequences on the Centre of Mass position have a pivotal influence on gait and balance, explaining both the initial impairments and the therapeutic effects. Gait analysis proves to be an effective tool to understand the pathophysiology of this patient, the therapeutic effects and mild residual gait defects in order to plan further rehabilitation strategy for this DRD patient. We propose that it will also prove to be useful for the exploration of other dystonic patients.
|
Authors | Rémi Rebour, Ludovic Delporte, Patrice Revol, Lisette Arsenault, Katsuhiro Mizuno, Emmanuel Broussolle, Jacques Luauté, Yves Rossetti |
Journal | Brain & development
(Brain Dev)
Vol. 37
Issue 6
Pg. 643-50
(Jun 2015)
ISSN: 1872-7131 [Electronic] Netherlands |
PMID | 25282485
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
|
Copyright | Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved. |
Chemical References |
|
Topics |
- Adult
- Biomechanical Phenomena
(drug effects)
- Dystonic Disorders
(complications, drug therapy)
- Female
- Gait
(drug effects)
- Humans
- Levodopa
(pharmacology, therapeutic use)
- Posture
- Treatment Outcome
- Young Adult
|