Trunk-lower limb coordination pattern during gait in patients with ataxia

Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Pietro Caliandro, Chiara Iacovelli, Carmela Conte, Chiara Simbolotti, Paolo M. Rossini, Luca Padua, Carlo Casali, Francesco Pierelli, Giuseppe Reale, Mariano Serrao
ObjectiveAlthough deficit of coordination between the upper and lower body segments might play an important role in impairing gait and stability in ataxic patients, this deficit has not been investigated in subjects with ataxia so far. To evaluate the coordination between trunk and thigh in a sample of patients with ataxia compared with healthy controls and to correlate the coordination measures with the clinical severity.DesignProspective observational study.SubjectsSixteen patients with degenerative cerebellar ataxia and sixteen age- and sex-matched controls were studied.MethodsWe assessed the coordination on the sagittal plane between trunk and thigh, considered as rigid segments, by the continuous relative phase (CRP) method. We used the coefficient of multiple correlation (CMC) to measure the within-subject (CMCWS) variability, and the SARA scale to assess clinical severity.ResultsCRP curves are dissimilar between ataxic patients and controls, the former showing a chaotic behavior compared to the well-shaped CRP curves observed in the latter. Trunk-thigh coordination has a higher within-subject variability in ataxic patients (median CMCWS: 0.53 for patients, 0.89 for controls, p<0.001). We also found that the CMCWS of the CRP curves negatively correlates with the gait (ρ: −0.565, p: 0.023) and stance (ρ: −0.567, p: 0.022) sub-scores and the total score of the SARA scale (ρ: −0.711, p: 0.002).ConclusionsAtaxia shows a deficit of spatio-temporal coordination between trunk and thigh. Such a deficit is correlated with the degree of the clinical impairment indicating an important role of inter-segmental coordination in determining the severity of ataxia.

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