Objective: This cross-sectional study investigated whether people with Parkinson’s disease (PD) demonstrate differences in head and trunk control during self-paced stair ascent and descent compared with age-matched controls.

Background: As one of the most challenging activities of daily life, stair ascent and descent pose a significant falls risk for people with PD. Research shows that head and trunk control are important to maintaining postural stability and previously it has been evaluated using harmonic ratios (HRs) derived from segmental accelerations. Using this measure, PD patients have been shown to have less rhythmic head and trunk movements than healthy adults which is believed to increase their risk of falling. Furthermore, such deficits in segmental rhythmicity are known to be further impaired in PD fallers compared with non-fallers. Despite this understanding, there is limited research evaluating segmental control during stair walking in PD.

Methods: Twelve PD patients and twelve age-matched controls completed assessments of cognition, quality of life, balance confidence and, where applicable, symptom severity. Head and trunk accelerations were then recorded using tri-axial accelerometers during a series of stair ascent and descent trials and raw data were processed to allow calculation of HRs and root mean square (RMS) accelerations. These data provided insight into anteroposterior (AP), mediolateral (ML) and vertical (VT) movement rhythmicity and amplitude, respectively.

Results: Linear mixed model analyses that incorporated walking speed as a covariate indicated that VT head and trunk movements were less rhythmic for the PD patients during stair descent, while VT RMS head accelerations and AP and VT RMS trunk accelerations were significantly reduced. PD patients walked significantly slower during stair ascent and while movement rhythmicity was similar for both groups during this task, PD patients had greater VT head and trunk accelerations that were independent of speed.

Conclusions: The less rhythmic head and trunk movements observed in people with PD during stair descent suggest that this population may be at a greater risk of falling during this task. This increased risk should be considered when working with this patient group to minimise their risk of falling.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/head-and-trunk-control-during-stair-ascent-and-descent-in-people-with-parkinsons-disease/