Abstract|Neurorehabilitation 2| Volume 357, SUPPLEMENT 1, e89, October 15, 2015

The activation of lower-extremity muscles during walking in different stage of Parkinson's disease

      Background: In the progression of Parkinson disease (PD), gradual derangement of the usage of lower extremity muscles are disabling. Therapeutic exercises has been effective on the mobility and balance.But the change of muscle activation pattern with progression of PD might give important information for therapeutic exercise implementation.
      Objective: The purpose of this study was to investigate the activation of lower-extremity muscles according to Hoehn-Yahr scale during gait.
      Patients and methods / material and methods: Thirty six Parkinson's patients (Hoehn and Yahr stage 1; 13, 63.1±7.8, stage 2; 15, 67.1±6.4, stage 3; 8, 63.7±8.7) participated in this study. Gait analyis was done with GAITRite system. We recorded EMG signals of the tibialis anterior (TA), medial gastrocnemius (MG), lateral gastrocnemius (LG), soleus (SOL), rectus femoris (RF), vastus lateralis (VL), semitendinosus (ST) and biceps femoris (BF) using Noraxon 16 channels EMG system during walking at preferred speed. Rectified EMG signals were normalized to reference voluntary contractions (RVC) over a gait cycle at the preferred speed.
      Results: In loading response, TA showed gradual attenuation throughout H&Y stages, but MG, LG showed gradual increment (p<0.05).
      In mid-stance and terminal stance, there was no significant changes except VL between H&Y stage 1 vs 3 in mid stance (p<0.05).
      In initial swing phase, TA and in terminal swing phase MG showed gradual attenuation throughout H&Y stages (p<0.05).
      Conclusion: In progression of PD, muscular exercise programs needs to focus on pretibial and calf muscles for good control over gait cycle.