Relationship between Muscular Activity and Postural Control Changes after Proprioceptive Focal Stimulation (Equistasi®) in Middle-Moderate Parkinson's Disease Patients: An Explorative Study

Fabiola Spolaor, Marco Romanato, Guiotto Annamaria, Antonella Peppe, Leila Bakdounes, Duc-Khanh To, Daniele Volpe, Zimi Sawacha, Fabiola Spolaor, Marco Romanato, Guiotto Annamaria, Antonella Peppe, Leila Bakdounes, Duc-Khanh To, Daniele Volpe, Zimi Sawacha

Abstract

The aim of this study was to investigate the effects of Equistasi®, a wearable device, on the relationship between muscular activity and postural control changes in a sample of 25 Parkinson's disease (PD) subjects. Gait analysis was carried out through a six-cameras stereophotogrammetric system synchronized with two force plates, an eight-channel surface electromyographic system, recording the activity of four muscles bilaterally: Rectus femoris, tibialis anterior (TA), biceps femoris, and gastrocnemius lateralis (GL). The peak of the envelope (PoE) and its occurrence within the gait cycle (position of the peak of the envelope, PPoE) were calculated. Frequency-domain posturographic parameters were extracted while standing still on a force plate in eyes open and closed conditions for 60 s. After the treatment with Equistasi®, the mid-low (0.5-0.75) Hz and mid-high (0.75-1 Hz) components associated with the vestibular and somatosensory systems, PoE and PPoE, displayed a shift toward the values registered on the controls. Furthermore, a correlation was found between changes in proprioception (power spectrum frequencies during the Romberg Test) and the activity of GL, BF (PoE), and TA (PPoE). Results of this study could provide a quantitative estimation of the effects of a neurorehabilitation device on the peripheral and central nervous system in PD.

Keywords: balance assessment; gait analysis; neurorehabilitation device; parkinson’s disease; surface electromyography; wearable focal mechanical vibrations device.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study design.
Figure 2
Figure 2
Romberg Test. Differences in the treatments effect and controls accounting for the low and high bands of the postural oscillation. Results are reported in both the medial-lateral component (x) and anterior-posterior component (z). *: Statistically significant difference (p < 0.05) between the before-after condition with the Wilcoxon signed rank test (p < 0.05). red † indicate the outliers.
Figure 3
Figure 3
Envelope mean ± 1 standard deviation extracted from the surface electromyographic signal of each muscle analyzed: On the y-axis, the peak of the envelope (PoE in % of mean activation during gait), on the x-axis, the gait cycle (from 0 to 100%). The bottom on the left tibialis anterior (TA) and on the right gastrocnemius lateralis (GL); down on the left rectus femoris (RF) and on the right biceps femoris (BF). In blue PoE before Equistasi®, in red after Equistasi®, and in yellow normative bands of control subjects. Blue *: Before Equistasi® compared with controls; red *: After Equistasi® compared with controls; green *: Before Equistasi® compared with controls after Equistasi®.
Figure 4
Figure 4
Envelope mean ± 1 standard deviation extracted from the surface electromyographic signal of each muscle analyzed: On the y-axis, the peak of the envelope (PoE in % of mean activation during gait), on the x-axis the gait cycle (from 0 to 100%). The bottom on the left tibialis anterior (TA) and on the right gastrocnemius lateralis (GL); down on the left rectus femoris (RF) and on the right biceps femoris (BF). In blue, PoE before placebo, in red after placebo, and in yellow normative bands of control subjects. Blue *: Before placebo compared with controls; red *: After placebo compared with controls; green *: Before placebo compared with after placebo.

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