Cumulative effect of Levodopa in obstacle crossing: Case study of a Parkinson disease patient

Abstract

The locomotor behavior of individuals with Parkinson’s disease (PD) is strongly affected by the Levodopa kinetics. Then, our aim was to analyze indirectly the Levodopa kinetics on the locomotor behavior during one day by means of the gait kinematic analyses during obstacle avoidance of one PD patient in advanced stage. WM, man, 72 years of age, 18 years with PD, stage IV of the disease, participated in this study. WM presented the following history: PD initiated by tremors of the right hand followed by tremors on the left hand, rigidity in the right lower limb first and on the left lower limb latter and then the cervical region; palidotomy 10 years ago decreasing the tremors. WM came into the lab for testing twice in the same day. During the afternoon, the patient presented larger improvements in his motor functions. The spatial and temporal parameters of the free walking and the obstacle avoidance revealed a cumulative effect of the motor responses to the Levodopa. This effect was observed by improvements in all variables and their variability. WM used adaptive locomotor strategies during obstacle avoidance. The Levodopa was efficient to normalize the gait pattern during the day.