Plantar cutaneous sensory stimulation improves single-limb support time, and EMG activation patterns among individuals with Parkinson's disease

Jenkins, M.E.; Almeida, Q.J.; Spaulding, S.J.; van Oostveen, R.B.; Holmes, J.D.; Johnson, A.M.; Perry, S.D.

doi:10.1016/j.parkreldis.2009.04.004

« Previous Next »Parkinsonism & Related Disorders
Volume 15, Issue 9 , Pages 697-702, 5 November 2009

Plantar cutaneous sensory stimulation improves single-limb support time, and EMG activation patterns among individuals with Parkinson's disease

M.E. Jenkins
- Department of Clinical Neurological Sciences, Schulich School of Medicine, University of Western Ontario, Canada
- Corresponding author at: Department of Clinical Neurological Sciences, Schulich School of Medicine, The University of Western Ontario, London Health Sciences Centre, 339 Windermere Road, Room A10325, London, Ontario, Canada N6A 5A5. Tel.: +1 519 663 3404; fax: +1 519 663 3416.
Q.J. Almeida
- Movement Disorder Research and Rehabilitation Centre, Wilfrid Laurier University, Canada
S.J. Spaulding
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, Canada
R.B. van Oostveen
- Movement Disorder Research and Rehabilitation Centre, Wilfrid Laurier University, Canada
J.D. Holmes
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, Canada
A.M. Johnson
- Bachelor of Health Sciences Program, Faculty of Health Sciences, University of Western Ontario, Canada
S.D. Perry
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, Canada

Received 7 October 2008; received in revised form 7 April 2009; accepted 13 April 2009.

Abstract

Parkinson's disease is a chronic neurological disorder that results in gait and posture impairment. There is increasing evidence that these motor impairments may be partially due to deficits within the sensory system. In this study, the effects of a facilitatory insole that provides increased plantar sensory stimulation, was evaluated during gait, in a group of individuals with Parkinson's disease in comparison with healthy age-matched controls. Spatial–temporal parameters of gait were evaluated using an instrumented carpet, and muscle activation patterns were evaluated using surface EMG. All participants were tested with both a facilitatory (ribbed) insole and a conventional (flat) insole while walking 20 feet. Results indicated that the use of the facilitatory insole produced a significant increase in single-limb support time. Additionally, the muscle activation sequence of the tibialis anterior was normalized by the facilitatory insole, at the time of initial ground contact. These changes may lead to an overall improvement in gait pattern and stability, and suggest that the use of this type of facilitatory insole may be a useful treatment strategy for improving the gait of individuals with Parkinson's disease. This also provides support for the role of facilitation of the sensory system in improving motor output in individuals with Parkinson's disease.

Keywords: Parkinson's disease, Gait, Kinematics, EMG, Facilitatory insole