Levodopa Is a Double-Edged Sword for Balance and Gait in People With Parkinson’s Disease

 In Health, Mobility Lab

How much does Levodopa really help?

A recent study by APDM partner Oregon Health and Science University found interesting conclusions regarding the use of Levodopa in people with Parkinson’s Disease (PD). The study looked at Levodopa responsiveness in relation to balance and gait function – a controversial topic. APDM Mobility Lab software was used to extract all gait and balance parameters.

This is the first study to compare Levodopa responsiveness on balance, gait, and postural transitions (gait initiation and turning) in the same large cohort of patients with idiopathic PD.

The study concluded the following:

L-dopa is a double-edged sword for treating mobility dysfunction in people with PD. When on, subjects with PD walked and turned more quickly, but became less stable during quiet standing and probably turning. Dyskinesia, rather than disease severity, accounted for these negative effects of L-dopa.

 

– Levodopa improved, but did not normalize gait

Pace-related gait metrics improved with Levodopa, specifically stride velocity, stride length, lower leg range of motion, arm swing range of motion, and arm swing velocity. A few smaller effects were seen in increased anticipatory postural adjustments (APAs) during step initiation, and improved turning metrics.

 

– Levodopa worsened balance

Postural Sway metrics worsened with Levodopa, specifically Sway Dispersion (RMS Sway) and Sway Velocity, indicating that subjects with PD were less stable when on Levodopa. Dynamic stability metrics like gait cycle Double Support and Swing time saw no change.

 

– The effects of Levodopa on balance and gait were influenced by the presence of dyskinesia

Dyskinetic subjects swayed significantly more with Levodopa, and the percentage of subjects with recurrent falls over the past year tended to be higher in the group with dyskinesia than the group without.

 

OHSU took advantage of APDM Mobility Lab’s ability to quickly and objectively measure subjects. Automatic data interpretation means the researchers could see immediate results after a mobility test was initiated. In Mobility Lab, this data can be seen in raw form, or shown compared to normative values and standard deviations.

Learn more about Mobility Lab here.

See the full article here.

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