Objective: Participants with PD were able to improve postural stepping responses with practice and this learning was improved by levodopa.

Background: Protective steps in response to postural perturbation (e.g. slips) are critical to avoid falls and are impaired in people with Parkinson’s disease (PD). Training may improve protective stepping; however, given the importance of dopamine for motor learning, people with PD may have an altered ability to improve reactive stepping. Further, levodopa, a commonly prescribed dopamine replacement drug, may affect how people learn. The degree to which dopamine replacement therapy with levodopa affects the ability to learn stepping responses is unknown.

Methods: Twenty two people with PD completed 4 visits to assess improvements in protective stepping, retention of these improvements over 24 hours, and retention of these improvements both ON and OFF levodopa. The primary outcome was peak displacement of the center of mass (COM) after the perturbations.

Results: People with Parkinson’s disease exhibited more pronounced improvement, retention, and generalization of protective stepping after training while ON levodopa with respect to OFF levodopa.

Conclusions: Individuals with Parkinson’s disease are able to improve protective stepping responses through short-term training. These improvements are more pronounced when ON levodopa. Although more research is necessary, these results suggest that protective step training may be more effective if completed while optimally medicated with levodopa.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-levodopa-on-adaptation-of-reactive-stepping-in-people-with-parkinsons-disease/