Adaptation of gait termination on a slippery surface in Parkinson's disease

Parkinson's disease (PD) causes instability and difficulty adapting to changing environmental and task demands. We examined the effects of PD on the adaptation of gait termination (GT) on a slippery surface under unexpected and cued circumstances. An unexpected slip perturbation during GT was followed by a slip perturbation during GT under two conditions: planned over multiple steps and cued one step prior to GT. Feed forward and feedback-based responses to the perturbation were compared to determine (1) how PD affects the ability to integrate adaptive feed forward and feedback-based GT strategies on a slippery surface, (2) if adaptations can be implemented when GT is required within one step, and (3) if behaviour changes with repeated exposure. Similar to the control group (n=10), the PD group (n=8) adapted and integrated feed forward and feedback-based components of GT under both stop conditions. Feed forward adaptations included a shorter, wider step, and appropriate stability margin modifications. Feedback-based adaptations included a longer, wider subsequent step. When cued to stop quickly, both groups maintained most of these adaptations: foot angle at contact increased in the first cued stop but adapted with practice. The group with PD differed in their ability to adapt GT with slower, wider steps and less stability.