Postural reflexes in Parkinson's disease during 'resist' and 'yield' tasks

Bastiaan R. Bloem, Dennis J. Beckley, Michael P. Remler, Raymund A C Roos, J. Gert van Dijk

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Postural reflexes in leg muscles appear to be set at a fixed gain in Parkinson's disease. To further investigate gain adaptation, we instructed 16 patients with idiopathic Parkinson's disease (studied during the 'off' phase) and 21 healthy controls to either 'resist' or 'yield' in response to 20 serial 4 ° toe-up perturbations of a supporting platform on which they were standing. We bilaterally recorded destabilizing medium latency (ML) reflexes from stretched gastrocnemius muscles and corrective long latency (LL) reflexes from shortened tibialis anterior muscles. We also assessed changes in center of foot pressure (CFP) and center of gravity (COG). During the 'resist' condition, patients had increased destabilizing ML reflexes, decreased corrective LL reflexes, increased backward displacement of the COG and increased forward (destabilizing) displacement of the CFP. In addition, the backward (corrective) displacement of CFP between 150 and 250 ms was delayed. During the 'yield' condition, reflex gains were modified in controls: LL reflexes were markedly attenuated, whereas ML reflexes were markedly increased. Although this reflex pattern resembled the 'resist' condition in patients, it was not associated with an increased forward displacement of the CFP, but only with a strongly delayed backward displacement of CFP which started after 150 ms. In patients, ML reflex amplitudes remained unchanged during the 'yield' condition, suggesting a fixed reflex gain. LL reflex amplitudes were reduced in patients but significantly less compared to controls, which again suggests a fixed reflex gain. This 'inflexibility' of postural reflexes was reflected by the CFP which showed much smaller changes between 0 and 250 ms in patients than controls. These results could not be ascribed to a different ability to yield because posterior displacement of the COG was identical in patients and controls during the 'yield' condition. We conclude that (1) patients with Parkinson's disease have abnormal and 'inflexible' postural reflexes, associated with delayed corrective movements about the ankle joint and increased body sway; and (2) the increased forward displacement of the CFP in patients likely reflects high stiffness in ankle muscles because reflex changes in controls only affected the CFP more than 150 ms after the perturbation. The increased muscle stiffness and inflexibility of postural reflexes in Parkinson's disease may contribute to balance impairment in daily life.

Original languageEnglish (US)
Pages (from-to)109-119
Number of pages11
JournalJournal of the Neurological Sciences
Volume129
Issue number2
DOIs
StatePublished - 1995

Fingerprint

Parkinson Disease
Reflex
Foot
Pressure
Muscles
Gravitation
Hypergravity
Abnormal Reflexes
Aptitude
Ankle Joint
Toes
Ankle
Leg
Skeletal Muscle

Keywords

  • Balance
  • Gain
  • Instability
  • Parkinson's disease
  • Postural set
  • Reflex

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Aging
  • Surgery
  • Developmental Neuroscience
  • Neuroscience(all)

Cite this

Bloem, B. R., Beckley, D. J., Remler, M. P., Roos, R. A. C., & van Dijk, J. G. (1995). Postural reflexes in Parkinson's disease during 'resist' and 'yield' tasks. Journal of the Neurological Sciences, 129(2), 109-119. https://doi.org/10.1016/0022-510X(94)00253-K

Postural reflexes in Parkinson's disease during 'resist' and 'yield' tasks. / Bloem, Bastiaan R.; Beckley, Dennis J.; Remler, Michael P.; Roos, Raymund A C; van Dijk, J. Gert.

In: Journal of the Neurological Sciences, Vol. 129, No. 2, 1995, p. 109-119.

Research output: Contribution to journalArticle

Bloem, BR, Beckley, DJ, Remler, MP, Roos, RAC & van Dijk, JG 1995, 'Postural reflexes in Parkinson's disease during 'resist' and 'yield' tasks', Journal of the Neurological Sciences, vol. 129, no. 2, pp. 109-119. https://doi.org/10.1016/0022-510X(94)00253-K
Bloem, Bastiaan R. ; Beckley, Dennis J. ; Remler, Michael P. ; Roos, Raymund A C ; van Dijk, J. Gert. / Postural reflexes in Parkinson's disease during 'resist' and 'yield' tasks. In: Journal of the Neurological Sciences. 1995 ; Vol. 129, No. 2. pp. 109-119.
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